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A  NEW  CLINICAL  TEST  FOR  TEMPERATURE  SENSITIVITY 

A  CONTRIBUTION  TO  THE  STUDY  OF 

TEMPERATURE  REACTION  IN  NERVOUS  DISEASES 

BASED  ON  THE  REACTION  TO  SIMULTANEOUS 

COLD  AND  HOT  STIMULATION 

An  two  parts^ 


ETHEL   LETITIA   CORNELL,  A.B. 

DEPARTMENTS  OF  PSYCHOLOGY  AND   NEUROLOGY 

COLUMBIA  UNIVERSITY 

NEW  YORK  CITY 


SUBMITTED  IN  PARTIAL  FULFILLMENT  OF  THE 

REQUIREMENTS  FOR  THE  DEGREE  OF   DOCTOR  OF  PHILOSOPHY 

IN   THE    FACULTY   OF    PHILOSOPHY 

COLUMBIA    UNIVERSITY 


Colunrfjia  ^HntbErgitp 
intteCitpof^etogorfe 

CoUege  of  ^bpSitianS  anb  g>urgeong 


Reference  Hibrarp 


A  NEW  CLINICAL  TEST  FOR  TEMPERATURE  SENSITIVITY 

A  CONTRIBUTION  TO  THE  STUDY  OF 

TEMPERATURE  REACTION  IN  NERVOUS  DISEASES 

BASED  ON  THE  REACTION  TO  SIMULTANEOUS 

COLD  AND  HOT  STIMULATION 


(in 


TWO    PARTS 


BY 

ETHEL   LETITIA   CORNELL,  A. B. 

DEPARTMENTS  OF   PSYCHOLOGY  AND   NEUROLOGY 

COLUMBIA  UNIVERSITY 

NEW  YORK  CITY 


SUBMITTED   IN   PARTIAL   FULFILLMENT  OF  THE 

REQUIREMENTS  FOR  THE   DEGREE  OF   DOCTOR  OF  PHILOSOPHY 

IN    THE    FACULTY    OF    PHILOSOPHY 

COLUMBIA    UNIVERSITY 


REPRINTED   FROM  VOL.   I,  NO.  J,  PAGES  II9-I58,  AND  VOL.    I,  NO.  9,  PAGES  335-372 

THE     NEUROLOGICAL     BULLETIN 

PUBLISHED  MONTHLY  BY  PAUL  B.  HOEBER,  NEW  YORK 
COPYRIGHT,  1918 


Q"PSt)l 


/    L 


A  NEW  CLINICAL  TEST  FOR  TEMPERATURE 
^'  SENSITIVITY 

J^  BASED  ON  THE  REACTION  TO  COLD  AND 

HOT  STIMULI  SIMULTANEOUSLY  APPLIED 

By  ETHEL  L.  CORNELL,  A.B. 
~-^  Departments  of  Neurology  and  Psychology,  Columbia  University 

-'     ^  NEW  YORK  CITY 


GENERAL  OUTLINE 


Historical 
Experimental 

Statement  of  problem 

Apparatus 

Material  and  Method 

Subjects,  Areas  tested,  Arrangement  ol  Series, 
Temperatures  used 

Procedure 

Conditions  aflfecting  results 
Limitations  of  method 
Changes  in  temperature  of  skin  or  stimulus 
Topography  of  warm  and  cold  spots 

Results 

General  character  of  reactions  to  double  stimuli 
Proportion  of  responses  giving  cold  first 


Proportion  of  responses  giving  only  one  sen- 
sation 

Reaction  to  single  stimuli 

Overlapping  of  reaction-time  to  cold  and  hot 
Responses  giving  both  sensations 

Detailed  consideration  of  responses  to  double 
stimuli 
Responses  giving  hot  first — comparison  with 

those  giving  cold  first 

Responses  giving  cold  first 

General  distribution 

Effect  of  double  stimulus  on  reaction-time 
to  hot 

Summary  of  individual  cases 

Conclusions 


HISTORICAL 

A  review  of  the  literature  on  the  tempera- 
ture senses  is  a  task  of  rather  large  dimensions. 
There  are  so  many  factors,  however,  influenc- 
ing any  investigation  in  this  field,  and  there  is 
so  little  in  the  literature  that  bears  specifically 
on  the  present  problem,  that  I  shall  attempt  to 
give  a  somewhat  sketchy  survey  of  the  whole 
field. 

The  problems  attacked  have  been  many, 
the  methods  of  approach  various,  and  the  con- 
clusions of  all  possible  degrees  of  diversity;  so 
that  it  is  not  always  easy  to  give  a  very  clear 
presentation.  Indeed,  one  fervently  reechoes 
the  words  of  Trotter  and  Davies:  "The  study 
of  thermal  sensitivity  is  a  peculiarly  difficult 
one,  not  only  in  regard  to  technical  detail, 
but  especially  in  regard  to  obtaining  clear 
conceptions  and  expounding  them  without 
confusion."  ^ 

'J./.  Psychol,  u.  Neurol..  20,  1913.  p.  E  106. 


There  seem  to  be  four  general  classes  of 
problems  that  have  been  investigated  in 
regard  to  the  temperature  senses — four  general 
methods  of  approach,  which  while  not  mu- 
tually exclusive,  are  sufficiently  distinct  to 
give  a  certain  coherence  to  the  discussion. 
These  four  classes  are: 

1 .  The  psychophysical — under  which  I  have 
classed  the  various  problems  of  sensitivity  that 
occupied  so  large  a  part  of  the  earlier  litera- 
ture— problems  of  the  threshold  values  of  sen- 
sation, of  discrimination,  and  of  the  limiting 
values  where  sensations  of  temperature  pass 
over  into  those  of  pain;  and  the  question  of 
topography — the  relative  sensitivity  of  vari- 
ous parts  of  the  body. 

2.  The  physiological — which  took  its  im- 
petus from  the  question  of  the  specific  energies 
of  the  nerves,  because  of  the  apparent  con- 
tradiction that  cutaneous  sensations  ofTered 
to  this  theory.    Under  this  class  will  fall  the 


Reprinted  from  the  March,  IQ18,  issue  of  the  Neurological  Bulletin,  Vol.  I,  No.  j, 
pages  Jig-158.    Copyright,  igi8 

119 


'IViiiix-raturc  Sciisiti\  ity 


question  of  the  nature  and  distribution  of  the 
end-organs  (closely  allied  to  the  topography), 
the  question  of  the  nature  of  the  arousal  of 
the  sensation  and  the  consequent  explanations 
of  adaptation,  and  the  question  of  the  con- 
stitution of  the  nerves  which  was  raised  by  the 
recent  work  of  Head. 

3.  The  psychological — which  is,  to  be  sure, 
bound  up  with  all  the  rest,  but  under  which 
I  have  chosen  to  consider  the  questions  related 
chiefly  to  qualities  of  sensation  and  reaction- 
time. 

4.  The  clinical — which  is,  to  a  great  extent, 
merely  the  application  of  results  obtained  by 
other  methods  to  abnormal  cases.  It  has, 
however,  set  many  of  the  problems  under  the 
other  headings,  and  has,  besides,  its  peculiar 
problems  of  sensory  dissociation  to  treat. 

PSYCHOPHYSICAL  INVESTIGATIONS 

It  is  quite  fitting  to  begin  from  the  psycho- 
physical point  of  view,  since  the  very  first 
recorded  observations  are  those  of  Weber  (24), 
that  a  metal  cylinder  of  15°  C.  felt  colder  on 
some  parts  of  the  body  than  on  others,  and 
similarly,  one  of  40°  felt  warmer  in  some  places 
than  in  others.  Fechner,  also,  did  not  omit 
to  test  temperature  sensitivity  to  corroborate 
Weber's  law;  but  these  experiments  we  may 
pass  over,  to  consider  the  more  specific 
attempts  to  measure  temperature  sensitivity. 

Threshold  values  may  here,  as  in  other 
cases,  be  of  three  sorts,  although  our  authors 
have  not  always  distinguished  them  very 
clearly.  The  stimulus  limen  (R.  L.)  would 
correspond  to  the  least  difference  from  the 
skin  temperature  that  could  be  sensed;  the 
difference  limen  (D.  L.)  would  correspond  to 
the  least  noticeable  difference  between  two 
stimuli  at  other  than  skin  temperature;  the 
terminal  limen  (T.  R.)  would  be  the  limiting 
value  where  sensations  of  temperature  ceased 
to  be  felt  as  such.  The  first  experiment  of  this 
sort  was  that  of  Nothnagel  (16),  in  1866.  He 
used  two  small  cylindrical  vessels  filled  with 
water,  each  fitted  with  a  thermometer  dipping 
into  the  water.  The  water  was  heated  or 
cooled  to  the  desired  temperature  by  inserting 
into  it  a  large  key  previously  heated  or  cooled. 
The  two  vessels  were  applied  successively  to 
the  same  spot,  and  the  discriminati%e  interval 


determined.  He  made  out  discrimination 
tables  for  various  parts  of  the  skin  surface, 
as  a  starting  point  for  the  investigation  of 
pathological  conditions,  in  which  he  was 
primarily  interested.  Discrimination,  which 
he  found  to  be  best  between  27°  and  33°  C, 
varied  from  .2°  on  the  forearm,  upper  arm, 
and  cheek — the  most  sensitive  parts — to  1.2° 
in  the  middle  of  the  back.  At  that  time,  of 
course,  the  separation  of  thermal  sensations 
into  two  separate  series  had  not  been  thought 
of;  consequently,  Nothnagel's  values  may  be 
sometimes  true  difference  thresholds  and 
sometimes  may  represent  the  absolute  thresh- 
old, or  least  noticeable  sensation  for  cold  or 
warm.  After  the  distinction  had  been  made, 
Eulenberg  made  an  attempt  to  determine  the 
least  differences  above  and  below  the  skin 
temperature  that  could  be  perceived  as  warm 
and  cold  respectively  (7).  Eulenberg's  ap- 
paratus was  somewhat  more  refined.  He  used 
two  thermometers  with  flattened  bases,  one 
of  which  had  its  base  wound  with  a  platinum 
wire  through  which  a  current  could  be  sent 
to  raise  the  temperature  of  the  base.  The 
heat  was  controlled  by  a  rheostat.  One  ther- 
mometer was  placed  on  the  skin  and  left  until 
it  registered  the  skin  temperature;  the  other 
was  then  heated  by  the  current  to  a  point 
slightly  above  or  below  this  and  set  down  in 
the  same  place.  Minimal  differences  perceived 
as  cold  and  warm  respectiv^ely  were  thus 
determined  for  \'arious  areas.    The  difference 

R.  L.  FOR  Cold  and  Warm  (Eulenberg) 


Minimal 

Minimal 

Cold 

Warm 

Difference 

Difference 

Sternum 

.2° 

.2° 

Fingers — dorsal 

.2 — 

•3 

.2 

Ball  of  thumb 

■:•,— 

•4 

•4 

Back  of  hand 

■3— 

•4 

•4 

Forearm — dorsal 

•3— 

•4 

.2 

Forearm — volar 

•4 

•3—   4 

Cheek 

•4 

•4 

Upper  arm 

•5 

•5 

Top  of  foot 

•5 

.5-  -6 

Leg — upi>er  part 

■5 — 

.6 

.5-  .6 

Leg — middle  part 

•7 

•7 

Thigh — ventral 

.6 

.5-  .6 

Back — lateral 

•9 

.9 — 1.0 

Back — median 

I.O 

I.I 

Temperature  Sensitivity 


for  each  sense  was  found  to  be  practically 
identical  for  the  same  area  of  the  skin,  and 
to  vary,  for  different  areas,  from  .2°  C.  in 
the  most  sensitive  parts  (stern urp,  back  of 
fingers)  to  l°  or  i.i°  on  the  back. 

The  third  sort  of  threshold — the  pain 
threshold  for  thermic  stimuli — was  first  inves- 
tigated by  Donath,  whose  work  was  published 
in  1884  (6).  He  contrived  two  instruments, 
one  for  investigating  cold-pain,  which  he 
designated  kn,'algimeter  (xp^o^ — cold,  oKyos — 
pain),  the  other  for  warm-pain,  which  he 
called  thermalgimeter.  The  kryalgimeter  was 
a  thermometer  ending  in  a  spiral  mercury 
vessel  which  fitted  exactly  into  an  opening  in 
a  piece  of  heavy  flannel.  This  was  placed  on 
the  skin  and  cooled  by  spraying  it  with  ether 
— the  flannel  protecting  the  surrounding  skin 
— until  a  sensation  of  pain  was  felt.  The 
thermalgimeter  was  a  similar  thermometer, 
ending  in  an  elongated  bulb  which  was  wound 
with  a  platinum  wire  through  which  a  current 
could  be  sent.  This  was  placed  on  the  skin, 
and  the  temperature  increased  until  pain  was 
reported.  He  found  noteworthy  individual 
differences  among  his  six  normal  subjects  and 
wide  variations,  according  to  the  part  of  the 
skin  stimulated,  from  — 11.4°  to  2.8°  C.  for 
the  appearance  of  cold-pain,  and  from  36.3° 
to  52.6°  for  warm-pain.  In  general,  ventral 
surfaces  were  more  sensitive  than  dorsal, 
upper  extremities  than  lower,  left  side  than 
right;  the  ends  of  the  fingers  were  the  least 
sensitive.  He  concluded  that  the  pain  aroused 
by  extreme  degrees  of  temperature  is  a  much 
grosser  sensation  than  that  from  the  middle 
intensities,  and  lacks  the  fineness  of  discrim- 
ination of  the  latter.  The  values  that  Donath 
obtained  for  cold-pain  seem  extraordinarily 
low,  and  suggest  that  his  method  may  have 
overlooked  the  effect  of  adaptation:  he  does 
not  state  how  long  the  contact  with  the  skin 
continued.  He  does,  however,  say  that  cold- 
pain  is  much  more  difhcult  to  recognize  and 
define,  and  arises  more  slowly  than  warm. 

Neumann,  in  1903,  investigated  the  same 
question,  in  regard  to  the  warm  sense  only, 
in  order  to  compare  the  interval  between  the 
sensation  of  warmth  and  that  of  pain  (15). 
He  used  a  metal  cylinder  partly  filled  with 
water  that  could  be  heated  by  an  electric  cur- 


rent. A  thermometer  was  inserted  into  the 
water  and  attached  to  the  handle;  the  handle 
also  had  a  little  plunger  by  which  the  water 
was  kept  constantly  circulating,  in  order  to 
assure  an  even  temperature  throughout. 
Neumann  found  that  while  the  threshold  for 
warm  might  vary  as  much  as  two  degrees  C. 
for  the  same  individual  in  the  same  place  at 
different  times,  the  threshold  for  pain  was 
fairly  constant  for  the  same  place  and  varied 
according  to  the  area  stimulated  from  35°  to 
52° — values  practically  identical  with  Do- 
nath's.  Both  Donath  and  Neumann  were 
interested  chiefly  in  pathological  conditions, 
and  their  work  will  be  referred  to  later. 

The  other  question  pertaining  to  sensitivity 
is  that  of  the  relative  sensitivity  of  different 
parts  of  the  body.  Goldscheider  was  the 
first  to  make  a  systematic  attempt  to  experi- 
ment upon  this  question.  His  earliest  experi- 
ments were  published  in  1887  (9a).  He  ex- 
plored the  skin  with  a  small  metal  surface 
that  had  been  heated  or  cooled,  and  divided 
sensitivity  into  twelve  degrees  of  intensity 
for  cold  stimulation  and  into  eight  for  warm. 
It  is  clear,  of  course,  that  the  actual  tempera- 
ture of  the  skin  in  this  case  is  of  great  impor- 
tance, and  also  the  proportion  of  warm  and 
cold  spots  in  the  various  areas.  Alrutz  re- 
peated topographical  experiments  after  adapt- 
ing each  area  tested  to  a  temperature  of  32° 
(2a).  He  was  able  to  differentiate  only  three 
degrees  of  sensitivity;  but  he  used  a  stimulus 
temperature  of  34.5°,  in  order  to  have  it  below 
the  point  at  which  the  cold  nerves  are  para- 
doxically stimulated  by  high  temperatures, 
while  Goldscheider  had  used  a  temperature 
of  45° — 49°.-  Such  radically  different  modes 
of  procedure  could  not,  of  course,  arrive  at 
the  same  results.  The  truth  probably  is  that 
these  differences  of  sensitivity  are  not  pecu- 
liarly areal  differences,  but  are  caused  by 
differences  in  skin  temperature  and  by  the 
presence  of  more  or  less  strongly  reacting 
spots  in  certain  areas.  Whether  these  spots 
have  any  constant  topographical  distribu- 
tion is  doubtful;  in  any  case,  it  could  only  be 

-  The  difference  is  more  tiian  one  of  metiiod.  It  is  due 
to  the  divergence  in  the  views  of  Goldscheider  and  Alrutz 
as  to  the  nature  of  the  sensation  of  heat — the  former  main- 
taining it  to  be  just  an  intensified  warm,  the  latter  a  fusion 
of  warm  and  paradoxical  cold. 


Temperature  Sensitivity 


determined  by  a  systematic  exploration,  point 
by  point. 

PHYSIOLOGICAL  INVESTIGATIONS 

It  was  originally  supposed  that  the  same 
nerves  conducted  all  cutaneous  impressions. 
It  was  not  until  1883  that  Blix,  who  was  in- 
terested to  determine  how  well-founded  was 
the  contradiction  that  cutaneous  sensations 
offered  to  the  theory  of  the  specific  energies 
of  the  nerves,  discovered  that  sensations  from 
various  kinds  of  cutaneous  stimuli  were  lim- 
ited to  permanent  spots — among  the  sensa- 
tions, those  of  cold  and  heat  (3).  The  same 
discovery  was  made  independently  at  about 
the  same  time  by  Goldscheider  (gb),  and  by 
Donaldson  (5).  Blix  used  an  induced  current 
with  a  pin  for  the  stimulating  electrode,  and 
found  that  distinctly  localized  spots  responded 
by  sensations  of  pain,  pressure,  cold,  and  heat, 
and  that  these  spots  were  never  superimposed. 
Other  methods  of  stimulation  confirmed  the 
results,  and  it  was  further  observed  that  a 
cold  spot  never  responded  to  a  warm  stimulus, 
nor  a  warm  spot  to  a  cold  stimulus.  Blix  con- 
cluded that  there  were  separate  cutaneous 
nerves  with  separate  terminations  in  the  skin. 
He  mapped  out  various  regions  of  his  own 
body  for  temperature  spots  and  found  them 
arranged  irregularly  in  groups,  distributed 
fairly  uniformly  over  the  body,  most  closely 
on  the  dorsal  side  of  the  hand  and  fingers, 
most  scattered  on  the  sacral  region  of  the 
back,  with  cold  spots  always  more  numerous 
than  warm.  Donaldson's  observations  con- 
firmed Blix's.  Goldscheider  found  a  much 
more  numerous  count,  but  his  method  was 
probably  at  fault,  since  later  work  has  cor- 
roborated Blix.  The  latest  and  most  com- 
plete observations  were  those  of  Sommer  (19), 
reported  in  1900.  He  found  (for  the  benefit 
of  anybody  who  is  statistically  minded)  a  total 
of  half  a  million  cold  spots  and  thirty  thousand 
warm — an  average  of  12-13  cold  spots  and 
1-2  warm  spots  per  square  centimeter. 

Donaldson  made  the  earliest  attempt  to 
discover  the  end-organs  associated  with  the 
sensations  of  warm  and  cold.  He  made  a 
histological  examination  of  a  piece  of  skin 
that  had  previously  been  explored  and  marked 
and  then  excised,  but  his  findings  were  entirely 


negative.  He  evidently  did  not  cut  deep 
enough,  for  he  found  that  the  recovering  area 
was  perfectly  sensitive.  Von  Frey,  whose 
work  was  published  about  ten  years  later,  has 
done  the  most  constructive  work  in  the  dis- 
covery of  the  nerve-endings  (23).  It  is  now 
generally  supposed  that  the  end-bulbs  of 
Kraus  mediate  cold  sensations,  and  the  Ruffini 
corpuscles  those  of  warmth. 

It  is  generally  assumed  that  the  warm  end- 
organs  lie  deeper  than  the  cold,  because  of 
the  greater  difficulty  in  localizing  warm  sensa- 
tions and  because  of  their  longer  reaction- 
time.  Thunberg  pointed  out  that  these 
assumptions  were  not  sufificient  proof ;  both  con- 
ditions might  be  due  to  the  nature  of  the  end- 
organ — Goldscheider  indeed  had  assumed  that 
the  warm  end-organs  had  a  longer  latent  time. 
Therefore  Thunberg  undertook  an  investiga- 
tion of  the  question  by  an  indirect  method 
{20b).  He  applied  silver  plates  of  the  same 
area  but  of  varying  degrees  of  thickness  to 
the  skin.  The  principle,  if  I  understand  it 
correctly,  was  as  follows:  Two  plates  of  the 
same  area  and  temperature,  but  of  different 
thickness,  will  add  warmth  to,  or  withdraw  it 
from  the  skin  in  different  amounts,  in  a 
measurable  proportion  to  the  thickness.  Since 
the  skin-temperature  is  a  balance  between  the 
temperature  of  the  blood  and  the  outer  tem- 
perature in  contact  with  the  skin,  the  amount 
of  warmth  added  to — or  withdrawn  from — 
the  skin  until  the  different  layers  of  the  skin 
reach  a  new  temporary  balance  will  be  a 
measure  of  the  depth  at  which  the  balance 
is  attained.  Consequently,  the  application  of 
a  very  intensive  stimulus  of  less  thickness  will 
have  a  greater  effect  on  the  more  superficial 
layers  than  on  the  deeper-lying  laj'ers  of  the 
skin;  while  on  the  other  hand,  a  stimulus  of 
less  intensity  but  greater  thickness  will  give 
a  relatively  favorable  opportunity  for  the 
stimulation  of  the  deeper  layers.  Since  then, 
as  Thunberg  found,  the  more  intense,  thinner 
plate  provided  the  optimum  conditions  for  the 
arousal  of  paradoxical  cold  sensations,  while 
a  stimulus  of  less  intensity  but  of  greater  mass 
offered  the  best  conditions  for  obtaining  a 
strong  warm  sensation,  he  concluded  that  the 
cold  nerve-endings  lie  more  superficially,  the 
warm  nerve-endings  deeper. 


Temperature  Sensitivity 


123 


The  question  of  the  depth  at  which  the  end- 
organs  lie  is  closely  connected  with  the  ques- 
tion, somewhat  theoretical  but  nevertheless 
important  in  its  practical  bearing,  of  the 
nature  of  the  arousal  of  thermal  sensations. 
Does  the  end-organ  change  its  temperature 
or  does  it  remain  constant?  If  it  changes,  do 
the  changes  take  place  in  the  same  direction 
as  the  changes  in  the  outer  skin-temperature 
or  in  the  opposite  direction?  It  is  generally 
considered  that,  since  the  skin-temperature 
is  found  to  be  differently  tempered  for  chang- 
ing conditions  of  temperature  without  arous- 
ing any  sensation,  there  is  a  zone  of  indifference 
— usually  called  the  "physiological  zero" — 
which  is  capable  of  shifting  up  and  down  the 
scale  within  rather  wide  limits.  But  Thunberg 
points  out  (20c)  that  we  have  no  proof  that 
the  temperature  of  the  end-organs  is  actually 
the  same  that  w^e  obtain  when  we  measure 
skin-temperature,  or  that  it  necessarily  changes 
in  the  same  direction.  What  we  get  by  measur- 
ing the  skin-temperature  is  a  balance  between 
the  different  layers  of  the  skin,  which  are 
normally  cooled  from  without  by  the  air  and 
warmed  from  within  by  the  blood.  But  when 
the  outer  layers  are  cooled  by  contact  with 
the  cold,  the  deeper  layers,  according  to 
Thunberg,  have  their  temperature  raised  by 
an  increased  flow  of  blood  to  restore  the  bal- 
ance; so  a  fall  of  temperature  toward  the  sur- 
face takes  place.  Somewhere  between,  there 
may  be  a  layer  that  maintains  its  own 
temperature.  Since  it  is  not  known  in  what 
layer  the  end-organs  are,  it  cannot  be  said 
what  is  the  nature  of  the  change.  There  are 
two  views  current:  that  of  Weber,  that  tem- 
perature sensation  is  due  to  change  of  skin- 
temperature  (or,  as  amended  by  Thunberg, 
to  change  in  the  layer  of  the  end-organ)  and 
lasts  as  long  as  the  change  lasts;  and  that  of 
Hering,  that  temperature  sensation  is  due  to 
the  actual  temperature  of  the  end-organ  and 
lasts  until  the  physiological  zero  reaches  a  new 
location — the  temporary  temperature  of  the 
end-organ.  According  to  Hering,  the  shifting 
physiological  zero — the  adaptation  to  any 
actual  temperature  of  the  end-organ — is  what 
accounts  for  the  absence  of  sensation,  though 
just  what  the  physiological  zero  is  is  not  clear. 
According    to   Weber,    any    relatively    stable 


temperature  following  a  period  of  change  is 
the  cause  of  the  absence  of  sensation.  The 
difference  in  the  two  views  is  due  partly  to 
differences  in  their  findings  as  to  the  duration 
of  sensation. 

An  experiment  to  determine  the  duration  of 
a  sensation  with  a  constant  stimulus  was  made 
in  1903  by  Holm  (10).  He  found  that  the 
duration  of  the  sensation  decreased  as  the 
temperature  of  the  stimulus  approached  that 
of  the  skin,  and  he  thought  this  suggested 
that  the  duration  of  the  sensation  probably 
agreed  with  that  of  the  temperature  change, 
since  prolongation  of  the  stimulus  did  not  pro- 
long the  sensation.  He  found  no  after-images 
with  stimuli  of  middle  intensities,  but  extreme 
cold  gave  rise  to  an  after-image  which  ap- 
peared some  moments  after  the  removal  of  the 
stimulus — due.  Holm  thought,  to  paradoxical 
cold  sensations  occasioned  by  a  quick  warming 
of  the  cooled  cold-organs  by  the  blood.  The 
absence  of  after-images  he  thinks  is  a  further 
support  of  Weber's  theory;  because  if  the 
absolute  temperature  were  effective,  one  would 
expect  after-images  with  weak  as  well  as  with 
strong  sensations. 

Duration  of  Sensation  (Holm) 

Cold 
Temperature         Average  Duration 


30° 

31  sec. 

25 

47 

20 

72 

15 

112 

10 

165 

5 

Warm 

210 

•peratui 

'e        Average  Duration 

40° 

126  sec. 

45 

152 

There  is  a  recent  study  on  the  effects  of 
adaptation  by  Edwina  Abbot,  which  suggests 
a  somewhat  different  conclusion  (i).  She 
made  four  groups  of  experiments  for  four  con- 
ditions of  adaptation.  In  the  first  group  her 
subjects  had  their  hands  adapted  to  a  tem- 
perature of  40°,  by  immersion  in  warm  water. 
Then  the  D.  L.  was  determined  by  dipping  the 
two  hands  into  separate  jars,  for  37.5°,  35°, 
32.5°,  30°,  27.5°,  25°,  22.5°,  17.5°.    She  found 


124 


Temperature  Sensitivity 


a  "consistent  drop"  in  the  D.  L.  at  32.5°.  In 
the  second  group,  she  determined  the  D.  L. 
for  40°,  32.5°,  27.5°,  25°,  after  adaptation  to 
various  temperatures.  She  found  that  the 
limen  for  32.5°  varied  hardly  at  all  under  the 
varying  conditions  of  adaptation.  This 
seemed  to  point  to  32.5°  as  a  condition  of 
adaptation  suitable  for  a  norm  by  which  to 
compare  the  limena  for  different  temperatures 
under  other  conditions  of  adaptation.  In  the 
third  group,  to  test  this,  she  compared  the 
D.  L.'s  for  various  temperatures  after  adapta- 
tion to  40°,  32.5°,  17.5°,  and  found  that  the 
D.  L.'s  for  32.5°  under  the  three  conditions  of 
adaptation  were  within  .5°  of  each  other,  while 
for  other  temperatures  the  D.  L.  rose  after 
adaptation  to  40°,  and  fell  after  adaptation  to 
17.5°.  The  fourth  group  was  undertaken  to 
test  the  possibility  of  a  double  adaptation — 
an  adaptation  to  both  extremes  at  once.  In 
this  group,  she  compared  the  effect  on  the 
D.  L.'s  for  various  temperatures  of  adaptation 
to  40°,  with  the  efi'ect  of  a  double  adaptation, 
to  40°  immediately  followed  by  adaptation  to 
17.5°.  The  values  for  the  D.  L.  were  practi- 
cally alike  in  this  experiment  for  extreme  tem- 
peratures, but  between  35°  and  27.5°  the 
D.  L.  was  higher  after  double  adaptation, 
except  again,  at  32.5°,  where  the  value  was 
about  the  same  for  both  conditions.  This 
was  considered  to  confirm  the  hypothesis.  All 
of  Dr.  Abbot's  results  suggested  that  varying 
conditions  of  adaptation  had  practically  no 
effect  on  sensitivity  at  normal  skin-tempera- 
ture, and  she  concludes  that  "persistence  of 
skin-temperature  as  a  more  or  less  constant 
basis  for  appreciating  variation  of  temperature 
is  a  much  more  possible  conception  than  the 
.  physiological  zero,"  "since  it  does  not 
fit  the  facts  .  .  .  and  since  the  facts  it  at- 
tempted to  explain  may  be  explained  without 
it."  Dr.  Abbot's  observations  were  not  very 
numerous,  however,  and  her  results  are  sug- 
gestive rather  than  conclusive. 

There  is  one  other  question  to  be  considered 
under  the  physiological  caption — the  question 
of  what  constitutes  an  adequate  stimulus  for 
warm  and  cold  spots.  Blix  had  first  used  an 
electrical  stimulus,  and  found  both  warm  and 
cold  spots  sensitive.  Kicsow  (11)  found  tem- 
perature spots  likewise  sensitive  to  electrical 


stimulation,  anil  to  mechanical  stimulation — 
if  the  observations  were  carefully  made,  if 
the  observer  was  sufficiently  practised,  and  if 
conditions  were  otherwise  favorable.  That 
is,  he  obtained  responses  to  mechanical  stim- 
ulation in  nine  out  of  thirty  tested  cold  spots, 
in  twenty-one  out  of  forty-si.x  trials;  in  ten 
out  of  thirty  trials  with  warm  spots  for  one 
observer,  five  out  of  fifteen  for  another,  and 
seven  out  of  ten  for  a  third.  The  percentage 
of  successes  is  not  startling,  but  is  enough, 
Kiesow  thinks,  to  prove  mechanical  stimula- 
tion possible.  Goldscheider  (9c),  Alrutz  (2c) 
and  others  have  confirmed  the  possibility  of 
mechanical  stimulation,  though  Head  (18) 
finds  no  evidence  of  it.  The  earlier  investi- 
gators had  found  that  cold  spots  never  re- 
sponded to  warm  stimuli,  nor  warm  spots  to 
cold.  Kiesow  tested  the  spots  by  means  of  the 
"opposite  stimulus"  and  got  a  rather  curious 
result.  He  never  got  a  cold  sensation  by  cold 
stimulation  of  a  warm  spot,  but,  on  the  other 
hand,  he  found  scarcely  a  cold  spot  that  would 
not  respond  to  temperatures  of  47°  to  50°  by 
a  sensation  of  warmth.  This,  Titchener  says, 
is  a  misreading  of  the  facts:  "In  reality,  radia- 
tion occurred,  and  the  process  observed  was 
not  that  of  warmth  but  of  heat."  '  However, 
paradoxical  sensations  of  cold — i.  e.,  cold 
sensations  from  a  warm  stimulus  applied  to 
a  cold  spot — were  discovered  by  von  Frey 
(23),  and  confirmed  by  Thunberg  (20a), 
Alrutz  (2d),  and  are  admitted  by  all.  Para- 
doxical warm  sensations  have  been  described 
by  Goldscheider,  but  no  other  investigator 
has  been  able  to  discover  them. 

PSYCHOLOGICAL  INVESTIG.\TIONS 

It  is  perhaps  somewhat  arbitrary  to  attempt 
to  separate  the  psychological  questions  from 
the  physiological,  but  I  have  reserved  this 
designation  for  the  investigations  relating 
chiefly  to  the  question  of  the  nature  and  qual- 
ity of  the  sensation  .  of  heat — the  question 
that  has  loomed  largest  on  the  psycholog- 
ical horizon  and  that  brings  about  a  trian- 
gular debate  between  Thunberg,  Alrutz,  and 
Goldscheider — and  for  the  determination  of 
the  reaction-time  to  cold,  warm,  and  hot 
stimuli. 

'Titchener.  'Quantitative  Instructor's!  Manual.'  p.  86. 


Temperature  Sensitivity 


125 


Paradoxical  cold  sensations  are  the  crux  of 
this  discussion.  While  everybody  admits  their 
existence,  there  is  considerable  diversity  of 
opinion  as  to  the  exact  manner  of  their  arousal 
and  the  interpretation  of  their  significance. 
Goldscheider,  who  originally  believed  they 
were  due  to  mechanical  stimulation,  now  ad- 
mits that  they  are  truly  paradoxical,  but  diffi- 
cult to  arouse  except  from  very  sensitive 
cold  spots  (gd).  He  says  they  never  appear 
with  a  stimulus  of  less  than  38°,  and  are  not 
a  frequent  phenomenon  with  temperatures 
below  4i°-45°.  Alrutz  and  Thunberg,  how-. 
ever,  find  paradoxical  cc5ld  sensations  a  con- 
stant phenomenon  from  temperatures  of  36°- 
38°  and  up  (2b,  20a).  Goldscheider  also  re- 
ports paradoxical  warm  sensations  from  cold 
stimuli  (of  2i°-27.5°);  consequently,  the 
significance  of  paradoxical  sensations  for 
Goldscheider  is  simply  as  another  means  of 
confirming  the  specific  nature  of  the  end- 
organs.  In  addition  to  paradoxical  cold  sen- 
sations by  point  stimulation,  Alrutz  and 
Thunberg  showed  that  they  could  be  obtained 
also  by  areal  stimulation  with  an  object  at  a 
fairly  high  temperature,  if  the  area  was  first 
adapted  to  moderate  warmth  for  two  minutes. 
These  facts,  and  the  absence  of  paradoxical 
warm  sensations,  in  their  observations,  led 
these  tAvo  investigators  to  the  belief  that  par- 
adoxical cold  sensations  were  an  essential 
element  in  the  sensation  of  heat.  Alrutz 
found  two  facts  in  his  earlier  work  that  con- 
firmed this:  first,  that  on  areas  of  the  skin 
where  cold  spots  are  lacking,  stimulation  by 
any  degree  of  heat  produces  warm  sensations 
and  pain  sensations,  but  never  heat;  second, 
that  on  areas  where  cold  sensitivity  was 
strongly  developed  but  warm  sensitivity  weak, 
sensations  of  heat  could  be  experienced  but 
never  strong  warm  sensations.  In  a  later 
paper  (2a),  Alrutz  added  a  third  proof  that 
the  hot  sensation  involved  the  stimulation  of 
cold  nerves,  from  experiments  in  reaction-time 
of  warm,  hot,  and  paradoxical  cold  sensations. 
Alrutz  found  that  hot  sensations  had  a  char- 
acteristic quality,  which  he  called  Anschwel- 
lung — a  sort  of  crescendo  effect  from  the  first 
perception  of  warm  to  the  full  perception  of 
hot.  This  meant  that  the  reaction  to  warm 
was  quicker  than  that  to  hot.     The  average 


reaction-time  for  warm  at  a  temperature  of 
42.5°,  is  3850-;  for  hot  at  about  the  same 
temperature,  7950-;  for  warm  at  43-44.5°, 
2670-;  for  hot  at  43-46.5°,  6240-.  This  longer 
time  for  the  perception  of  hot  Alrutz  finds  to 
be  parallel  with  the  reaction  for  paradoxical 
cold  sensation — 7450-  for  a  stimulus  of  42°, 
7500-  for  a  stimulus  of  51°. 

Alrutz's  figures  are  based  upon  rather  few 
observations,  but  he  compares  them  with  those 
that  Goldscheider  had  previously  obtained, 
and  finds  them  quite  similar.  Goldscheider 
had  found  a  quality  in  the  sensations  he  calls 
warm,  similar  to  the  Atischwellung  of  Alrutz's 
hot  sensations — that  is,  a  gradual  rise  from 
the  "minimum"  to  the  "maximum"  of  intensity. 

Reaction-Time  to  Hot  (Goldscheider,  Alrutz) 
Goldscheider 

Average 
Temperature        Minimum        Maximum 
35°  7  SO'' 

39  371  1,105'^ 

40  345  777 
44  282  585 
49                     283                    456 

Alrutz 

Temperature  Average  Time 

36.5°  805<r 

38.75  710 

43-5  576 

46.5  517 

50  544 

Alrutz  points  out  that  Goldscheider's  figures 
show,  as  he  contended,  a  greater  efifect  of  the 
stimulus  temperature  upon  the  hot  reactions 
than  upon  the  warm — /.  e.,  a  greater  decrease 
in  the  reaction-time  to  the  maximum  than 
to  the  minimum,  with  increasing  intensity  of 
the  stimulus.  Since  Alrutz  found  a  parallel 
decrease  in  the  reaction-time  to  paradoxical 
cold,  as  the  stimulus  temperature  rose,  he 
considers  this  conclusive  evidence  that  the 
sensation  of  heat  is  due  to  the  simultaneous 
stimulation  of  warm  and  cold  nerves. 

So  far,  Alrutz  and  Thunberg  agree,  but 
they  differ  as  to  the  quality  of  the  sensation. 
Alrutz  considers  it  an  unanalyzable  fusion. 
His  introspective  reports  show,  he  says,  that 
hot  is,  qualitatively,  a  sensation  having  the 
same  relation  to  warm  and  cold  that  orange 


126 


Temperature  Sensitivity 


bears  to  red  and  yellow,  similar  sometimes  to 
one,  sometimes  to  the  other,  but  never  separ- 
able into  the  two  components.  Thunberg,  on 
the  other  hand,  calls  hot  an  analyzable  fusion 
— he  thinks  it  possible  to  separate  the  element 
of  paradoxical  cold  from  the  dominating  hot 
sensation.  At  the  third  corner  of  the  triangle 
stands  Goldscheider,  who  considers  hot  simply 
as  an  intensive  warm  sensation,  quite  inde- 
pendent of  paradoxical  cold.  In  the  study 
published  in  1912  he  takes  up  the  argument  of 
Alrutz  point  by  point,  and  attempts  to 
demolish  it.  In  regard  to  the  first  argument, 
that  on  areas  where  cold  spots  are  lacking  no 
hot  can  be  felt,  Goldscheider  finds  that  prac- 
tically no  such  areas  exist.  (It  will  be  remem- 
bered that  he  found  a  more  numerous  count 
of  temperature  spots  than  other  investigators.) 
And  if  a  refutation  of  the  argument  is  needed, 
Goldscheider  finds  that  in  regions  where  there 
are  sensitive  warm  spots,  with  scattered,  not 
very  sensitive  cold  spots,  he  is  able  to  get 
quite  as  vivid  hot  sensations  as  on  areas  pro- 
vided with  strongly  sensitive  cold  spots.  The 
second  argument,  that  regions  that  possess 
strong  cold  but  weak  warm  sense  will  give  hot 
sensations  but  never  strong  warm,  Gold- 
scheider meets  again  by  the  opposite  experi- 
ence: he  gets  warm  and  burning  sensations 
but  never  hot.  As  for  the  third  argument,  that 
reaction-time  for  paradoxical  cold  agrees  with 
that  for  hot  and  that  therefore  paradoxical 
cold  is  significant  for  hot  sensation,  Gold- 
scheider considers  this  observation  doubtful 
because  of  its  great  difficulty  (he  points  out 
that  only  Alrutz  himself  made  these  observa- 
tions), and  that  even  if  true,  it  is  no  proof  of 
identity.  He  thinks  the  phenomenon  much 
more  explicable  on  the  theory  that  a  certain 
intensity  of  eff'ect  of  a  warm  stimulus — which 
naturally  must  depend  on  a  certain  duration 
of  the  contact — raises  the  intensity  of  excita- 
tion of  the  warm  nerv^es  to  the  state  where 
they  give  a  hot  sensation  and  that  this  in- 
tensity also  provides  the  condition  by  which 
cold  ner\es  are  stimulated  by  warm  stimuli. 
Other  considerations  too,  especially  that  the 
hot  sensation  is  strongest  on  areas  where  warm 
sensitivity  is  most  strongly  developed,  per- 
suade Goldscheider  that  Alrutz's  theory  is 
untenable.     To  this,  of  course,  Alrutz  would 


reply  that  Goldscheider's  determination  of 
warm  sensitivity  was  made  by  hot,  not  by 
warm  stimuli,  and  that  this  is  a  circular  argu- 
ment. The  question  cannot  be  decided  until 
unprejudiced  observers  have  contributed 
enough  evidence  to  outweigh  these  contra- 
dictory findings.  At  the  present  time,  I 
think  it  might  be  said  that  psychologists  in- 
cline to  agree  with  Alrutz,  while  physiologists 
find  themselves  in  accord  with  Goldscheider.* 

The  most  systematic  work  in  reaction-time 
to  sensations  of  temperature  has  been  done  by 
.Goldscheider  (9c,  p.  312  el  seq.).  He  devised 
a  rather  ingenious  device  for  measuring  the 
time.  The  stimulus,  a  small  brass  sphere  into 
which  a  thermometer  was  inserted,  was  ar- 
ranged by  means  of  levers  so  that  its  contact 
with  the  skin  closed  an  electric  circuit,  its 
removal  broke  the  circuit.  The  making  and 
breaking  of  the  current  were  noted  by  an 
electric  marker  on  a  smoked  drum  of  a  kymo- 
graph, on  which  a  time  marker,  controlled 
by  an  electric  tuning  fork,  indicated  hun- 
dredths of  a  second.  He  found  that  the  reac- 
tion-time depends  upon  the  intensity  of  the 
stimulus,  upon  the  threshold  value  of  the 
sensation,  and  upon  the  sensitivity  of  the  part 
of  the  body  tested. 

The  difference  in  reaction-time  of  different 
parts  of  the  body  is  shown  in  the  following 
table: 

Stimulus  iy°  C.     Slimulus  ^0°  C. 
Face  .135  sec.  .190  sec. 

Upper  extremity  .150  .270 

Abdomen  .226  .620 

Lower  extremity  .255  .790 

The  effect  of  the  stimulus-temperature  is 
shown  in  the  following  table.  The  region 
tested  was  the  left  forearm — an  area  moder- 
ately sensitive  to  cold,  with  a  skin-temperature 
of  32.5°,  and  an  area  quite  sensitive  to  warm, 
with  skin-temperature  32.7°. 

Stiniulus-Tempcratiire  Cold  Reaction 
30—29.5°  .399  sec. 

28.5—28  .381 

20—19  .377 

15-5—15  -278 

*  Except  those  who  follow  Head's  theor>'  of  the  constitu- 
tion of  the  nerves;  but  Head,  too,  while  he  separates  the 
mechanism  for  warm  and  hot  impressions,  postulates  a 
simple  sensory  "heat  spot."    Cf.  p.  128. 


Temperature  Sensiti\ity 


127 


w 

arm 

Reaction 

Mini 

muti 

Maximum 

•750 

sec. 

•371 

1. 105  sec. 

•345 

•Ill 

.282 

■585 

.283 

•456 

Stimulus-Temperature 

35° 
39 
40 
44 
4Q.5 

It  may  be  noted  that  for  cold  there  is  a 
marked  drop  in  the  reaction-time  at  15°,  while 
for  -warm  the  most  marked  drop  occurs  at  39°. 
The  latter  point  is  very  much  nearer  the  skin- 
temperature  than  the  former — a  result  that, 
if  constant,  is  a  little  puzzling. 

CLINICAL  IXVESTIGATIOXS 

Following  Fechner,  interest  was  much  stim- 
ulated to  the  investigation  of  thermal  sensa- 
tions. Nothnagel  pointed  out  in  1866  that 
temperature  sensibility  was  the  first  to  be 
disturbed  in  diseases  of  the  brain  and  spinal 
cord  and  in  neuroses.  He  established  norms 
of  discrimination  for  various  parts  of  the  body, 
as  has  already  been  explained,  with  which 
clinical  cases  might  be  compared.  He  found 
hypo-esthesia  to  be  the  general  rule — a  raising 
of  the  threshold  for  discrimination.  Often, 
however,  in  pathological  cases,  an  apparent 
hyperesthesia  occurs — an  increased  effect  of  a 
given  temperature,  apparently  greater  sen- 
sitivity— while  discrimination  remains  normal 
or  is  reduced.  This  method  did  not  prove  very 
valuable,  being  too  laborious  and  unneces- 
sarily fine. 

Donath  next  devised  a  method,  on  the  as- 
sumption that  the  important  thing  clinically 
was  to  discover  where  temperature  sensations 
passed  over  into  pain.  The  method  has  been 
described.  He  applied  it  to  the  examination 
of  thirteen  cases  of  tabes,  but  curiously,  he 
did  not  examine  the  same  cases  for  both  the 
warm-pain-threshold  and  the  cold-pain-thresh- 
old. He  found  that  warm-pain  usually  ap- 
peared at  a  higher  temperature  than  normally, 
and  cold-pain  usually  (though  not  always)  at 
a  lower.  He  concluded  that  the  pain  aroused 
by  cold  and  warm  was  a  much  grosser  sensa- 
tion than  the  perception  of  moderate  degrees 
of  temperature  and  lacked  the  possibilities  of 
discrimination  of  the  latter.  Neumann  also 
investigated  the  pain  threshold  for  warm 
stimuli.     In  four  cases  of  tabes  he  found  the 


thresholds  for  warm  and  for  pain  higher  than 
normal;  in  four  cases  of  spondylitis  he  found 
two  hypoesthetic  in  the  affected  region;  in 
six  cases  of  hysteria  he  found  three  normal, 
two  hypoesthetic,  and  one  hyperesthetic. 

Goldscheider  thought  that  the  sensitivity 
of  different  areas  would  be  a  good  clinical  test 
(9a).  He  made  a  topographical  map  of  the 
body  on  the  basis  of  the  intensity  of  sensation 
from  the  same  stimulus,  and  then,  in  cases  of 
disease,  compared  parts  that  normally  had 
a  constant  relation  to  each  other,  to  see  if  the 
sensitivity  was  affected.  Obviously,  the  lack 
of  any  control  for  the  introspective  com- 
parisons of  clinical  subjects  would  make  this 
method  of  slight  value. 

The  next  clinical  attempt  was  Leegaard's, 
who  took  as  his  point  of  departure  the  fact 
of  the  indifference  zone — the  region  of  the 
scale  at  and  near  the  skin-temperature  which 
is  not  felt  as  either  cold  or  warm  (13).  He 
used  little  copper  cylinders  which  were  applied 
to  the  same  spot  for  five  seconds  each,  begin- 
ning at  a  temperature  of  20°-25°  C,  and 
ascending  by  steps  of  .5°  until  the  lower  and 
upper  limits  of  the  indifference  zone  were 
reached.  He  found  that  normally  the  indif- 
ference zone  was  not  over  1°,  but  in  cases  of 
brain  and  cord  lesions  and  peripheral  affec- 
tions that  he  investigated,  it  might  vary  to 
any  extent.  In  one  case  of  hemiplegia,  for 
instance,  he  found  an  indifference  zone  of  26°, 
in  a  case  of  transverse  myelitis,  an  inditference 
zone  of  14°  in  the  affected  region.  These  are 
rather  interesting,  because,  while  Leegaard 
did  not  differentiate  two  senses,  and  while  his 
procedure  was  somewhat  questionable,  his 
experiments  in  a  way  anticipate  those  of  Head. 

The  possibility  of  using  tests  of  cutaneous 
sensitivity  as  a  means  of  differential  diagnosis, 
in  the  case  of  lesions  of  the  nervous  centers, 
is  partly'  effect  and  partly  cause  of  the  more 
recently  increased  knowledge  of  conduction 
paths.  Laehr  did  some  important  early  work 
in  distinguishing  different  types  of  partial 
sensory  dissociation  (12).  In  particular  he 
pointed  out  the  so-called  syringomyelic  type 
of  dissociation,  which  is  characterized  by  a  dis- 
turbance of  pain  and  temperature  and  the  pres- 
ervation of  contact  and  pressure  sensations. 
By   1905,   four  distinct   types  of  dissociation 


128 


Temperature  Sensitivity 


had  been  described.    Marinesco  (14)  classifies 
them  as  follows: 

(i)  Deterioration  of  all  forms  of  cutaneous  sensi- 
bility. 

(2)  Abolition  of  pressure  and  vibratory  senses  (or 
one  of  these  with  conservation  of  all  other  forms). 

(3)  Abolition  of  thermic  and  pain  senses  with  con- 
servation of  all  others  (syringomyelic  type). 

(4)  Impairment  of  thermic,  tactile,  and  pain 
sen.ses  with  conservation  of  pressure  and  vibratory 
sensations. 

An  entirely  new  direction  of  work  in  the 
sphere  of  sensory  dissociation  has  been  sug- 
gested within  the  last  decade  by  the  work  of 
Head  and  his  colleagues.  Head  had  the  radial 
nerve  in  his  arm  divided,  a  small  portion 
excised,  and  the  ends  sutured.  Then  he 
studied  the  return  of  sensation  to  the  area  of 
distribution  of  the  nerve.  His  most  complete 
report  (18)  was  published  in  1908.  His  find- 
ings were  that  sensitivity  returned  gradually: 
first,  to  pressure,  cutaneous  pain,  and  ex- 
tremes of  heat  and  cold,  accompanied  by  the 
phenomena  of  intensification  and  peripheral 
reference  of  the  sensation;  and  after  a  con- 
siderable interval  (160  to  400  days)  sensitivity 
to  light  touch,  to  moderate  degrees  of  tem- 
perature, and  the  discrimination  of  two  points 
simultaneously  applied.  His  conclusions  are 
familiar:  that  the  skin  is  supplied  by  two 
systems  of  nerves — one  providing  for  a  more 
fundamental,  reflex,  diffused  response  to  pain- 
ful stimuli  and  the  extremes  of  heat  and  cold 
("protopathic  sensibility") ;  the  other  produc- 
ing localized  responses,  discrimination  of  light 
touches,  of  two  points  simultaneously  applied, 
and  of  intermediate  degrees  of  temperature 
("epicritic  sensibility").  More  specifically,  in 
regard  to  temperature  he  found  that  on  the 
recovering  area  of  the  hand  that  was  in  a 
"protopathic"  condition,  punctate  stimuli  of 
about  17°  C.  were  the  first  to  be  sensed;  a 
little  later,  a  stinging  sensation  in  response  to 
punctate  stimulus  of  50°,  and  then  a  sensation 
of  heat  from  a  stimulus  of  45°.  As  sensitivity 
increased,  the  limits  approached  slightly 
nearer,  but  at  no  time  while  the  hand  was  in 
a  protopathic  condition  {i.  e.,  while  it  was  in- 
sensitive to  cotton  wool  and  unable  to  dis- 
criminate two  compass  points),  did  any  cold 
spot  react  to  a  temperature  above  26°  (e.xcept 


paradoxically  to  a  hot  stimulus),  nor  did  any 
"heat  spot"  react  to  any  temperature  under 
37°.  Only  particularly  sensitive  spots  reacted 
to  these  temperatures:  the  usual  limits  were 
about  20°  and  40°.  But  simultaneously  with 
the  restoration  of  sensitivity  to  cotton  wool, 
an  areal  stimulation  (by  a  surface  of  1.25  cm. 
diameter)  of  36°  to  34°  gave  a  warm,  well- 
localized  sensation  from  parts  where  no  "heat 
spots"  had  been  discovered.  Still,  however, 
punctate  stimulation  of  the  "heat  spots"  gave 
no  sensation  if  the  temperature  was  under 
38°.  With  cold,  the  experience  was  not  quite 
so  clear  but  seemed  to  Head  analogous.  With 
the  appearance  of  the  finer  discrimination,  no 
increase  in  the  number  of  heat  spots  was  ob- 
served; on  the  contrary,  the  separate  spots 
lost  their  increased  vividness.  The  recovered 
sensitivity  to  moderate  stimuli.  Head  thinks, 
cannot  be  due  to  the  regeneration  of  the  nerve, 
because  he  finds  that  a  similar  condition  ob- 
tains on  the  normaj  skin.  If  he  marked  out  all 
heat  and  cold  spots  in  a  normal  area,  and  then 
applied  a  stimulus  between  26°  and  37°  to  a 
small  area  where  no  spots  had  been  found,  such 
area  would  nevertheless  respond  with  the 
appr&priate  sensation.  He  concludes  there- 
fore, that  there  are  two  mechanisms,  one  punc- 
tate, which  responds  to  teinperatures  below 
26°  and  above  37°;  the  other  not  punctate, 
which  responds  to  areal  stimulation  between 
these  two  points. 

The  facts  of  adaptation  Head  finds  offer 
further  proof  of  different  mechanisms.  That 
epicritic  sensibility  depends  on  the  tempera- 
ture to  which  the  skin  is  adapted,  while 
protopathic  sensibility  does  not,  he  concluded 
from  the  following  observation:  If  both  hands 
were  adapted  to  water  at  50°,  a  copper  block 
at  29°  felt  cold  to  the  normal  hand,  but  gave 
no  sensation  on  the  protopathic  area;  simi- 
larly, after  adaptation  to  0°,  it  felt  warm  to  the 
normal  hand,  but  indifferent  to  the  proto- 
pathic area.  This  is  interpreted  as  meaning 
that  the  protopathic  condition  does  not 
undergo  the  shifting  of  the  threshold.  When 
both  hands  were  adapted  to  a  cold  of  10°,  a 
paradoxical  condition  arose  where  22°  pro- 
duced no  sensation  on  the  normal  hand  but 
gave  cold  sensation  on  the  affected  area.  This 
is  another  evidence,  Head  says,  of  the  fact 


Temperature  Sensitivity 


129 


that  the  protopathic  parts  are  incapable  of 
adaptation,  and  so  allow  the  cold  spots  to 
react  to  22°. 

This  experiment  has  been  repeated  by  sev- 
eral investigators.  Franz  (8)  supported  Head's 
contention  that  different  sets  of  nerves  pro- 
vide for  the  reception  of  extreme  and  medium 
stimuli,  but  he  regards  the  difference  in 
sensation  as  due  to  an  overlapping  of  the 
ner\'e  supply — a  possibility  that  Head  rejects. 
Trotter  and  Davies  repeated  the  experiment 
imder  elaborate  and  stringent  experimental 
conditions  (21).  The  results  they  obtained 
led  them  to  conclude  that  all  the  observed 
phenomena  were  phenomena  of  hypoesthesia 
due  to  the  regeneration  of  the  nerve  fibers 
and  that  all  forms  of  sensitivity  tended  to 
re-appear  at  about  the  same  time  in  a  hypo- 
esthetic  form,  except  sensitivity  to  hot,  which 
was  somewhat  delayed.  Their  observations  in 
regard  to  sensations  of  temperature  were  prac- 
tically identical  with  Head's,  but  their  inter- 
pretation is  quite  different.  Normally  they 
say  there  is  a  zone  of  the  temperature  scale 
in  the  neighborhood  of  the  skin  temperature 
which  is  indifferent  and  extends  over  about 
five  degrees  of  the  scale. '"  This  indifference 
zon«  can  be  shifted  up  or  down  by  warming 
or  cooling  the  skin.  As  the  distance  between 
the  skin-temperature  and  that  of  the  stimulus 
is  increased,  the  intensity  of  the  sensation  is 
increased,  and  it  is  generally  necessary  to 
have  a  difference  of  fifteen  degrees  before  the 
maximum  sensation  is  elicited.  Now  if  there 
is  a  general  reduction  in  the  thermal  sensi- 
tivity of  the  skin,  this  will  produce  an  increase 
in  the  range  of  the  intermediate  insensibility, 
and  a  diminution  in  the" intensity  of  the  sensa- 
tion produced  by  various  stimulus  tempera- 
tures. As  an  illustration:  Suppose  on  the 
normal  skin  a  stimulus  of  32°  is  indifferent, 
35°  slightly  warm,  38°  warm,  and  50°  hot;  if 
the  skin  is  hypoesthetic,  then  32°  and  35° 
will  both  be  indifferent,  38°  faintly  warm, 
50°  warm,  while  hot  perhaps  cannot  be  elicited 
at  all.  This  is  what  really  happens,  according 
to  Trptter  and  Davies,  in  the  hypo-esthetic 
zone  of  the  recovering  area,  and  partly  ac- 
counts for  the  delayed  reaction  to  hot.     Nor- 

'  This  is  a  much  wider  zone  tlian  the  results  of  any  of 
the  earlier  investigators  imply. 


maily,  a  stimulus  of  50°  produces  a  sensation 
of  hot,  accompanied  by  a  stinging  quality; 
in  the  hypoesthetic  area,  before  any  thermal 
quality  is  recognizable,  a  stinging  sensation 
is  produced  by  a  stimulus  of  50°. 

Trotter  and  Davies'  experiment  was  very 
carefully  done  and  seems  adequate  to  the 
facts  it  explains,  but  it  fails  to  account  for 
the  cases  reported  by  Head  where  epicritic 
sensibility  remained  after  the  protopathic 
type  was  destroyed.  There  is  some  evidence 
also  to  support  Head's  theory  that  the  two 
sorts  of  sensibility  are  conducted  by  different 
spinal  paths.  Ranson  has  attempted  to  show 
histologically  that  the  fibers  that  serve  epi- 
critic impulses  are  myelinated,  enter  the  dorsal 
columns  of  the  cord  from  the  larger  ganglia 
of  the  dorsal  roots,  and  ascend  on  the  same 
side;  while  those  that  serve  protopathic  im- 
pulses (pain,  and  extremes  of  temperature)  are 
unmyelinated  both  peripherally  and  centrally, 
enter  the  cord  from  smaller  ganglia,  cross  im- 
mediately to  the  other  side  of  the  cord  and 
ascend  in  the  lateral  columns.  Temperature 
impulses,  however,  are  an  exception  to  the 
uncrossed  epicritic  tracts,  and,  to  provide  for 
them,  a  few  of  the  myelinated  fibers  were 
found  to  cross  (17). 

The  literature  leaves  us  then,  in  a  rather 
inconclusive  state  as  regards  the  nature  of 
thermal  sensations  and  the  physiological  con- 
ditions of  their  arousal.  Authorities  differ,  on 
the  one  hand,  as  to  whether  hot  is  a  simple 
sensation  or  a  fusion  involving  both  warm  and 
paradoxical  cold  sensations;  and,  if  a  fusion, 
whether  it  can  be  analyzed  or  not.  On  the 
other  hand,  they  are  not  agreed  as  to  whether 
the  facts  of  dissociation  are  to  be  explained 
by  assuming  different  sensory  mechanisms 
for  extreme  and  medium  stimuli,  or  by  an 
overlapping  nerve  supply,  or  by  a  greatly 
diminished  sensitivity.  More  clinical  evidence 
of  a  searching  character  is  needed  before 
positive  conclusions  can  be  drawn. 

EXPERIMENTAL 
STATEMENT  OF  PROBLEM 

The  problem  that  I  here  present  in  its  pre- 
liminary results  is  that  of  devising  a  clinical 
test  of  temperature  sensitivity  that  may  be 


I30 


Temperature  Sensiti\ity 


of  some  ditignostic  \alue  in  certain  diseases 
of  the  nervous  system.  The  test  used  is  a 
test  of  reaction-time  to  two  distinctly  different 
stimuli  applied  simultaneously.  It  was  sug- 
gested by  Dr.  Tilney  that  a  disturbance  in 
the  response  to  simultaneous  stimuli  of  cold 
and  hot  might  be  apparent  at  an  earlier  stage 
than  would  appear  from  tests  of  either  sensa- 
tion alone,  and  might  consequently  be  of  early 
diagnostic  value.  This  part  of  the  experiment 
is  concerned  only  with  the  responses  of  nor- 
mal subjects,  and  the  problem  specifically 
stated  becomes:  \\hat  is  the  nature  of  the 
normal  indixidual's  reaction  to  two  stimuli, 
one  cold,  one  hot,  applied  simultaneously  to 
immediately  adjacent  areas  of  the  skin,  in 
various  regions  of  the  skin  surface? 

APPARATUS 

The  stimulus  was  applied  by  means  of  little 
blocks  of  soft  iron,  attached  to  wooden  han- 
dles, bearing  a  letter  or  number  for  ease  of 
identification.  These  blocks  were  of  two  sizes, 
to  suit  the  areas  tested — the  larger  ones  were 
two  inches  long,  one  and  one-half  inches  wide 
and  one-quarter  inch  thick;  the  smaller,  one 
inch  by  three-quarters  by  one-quarter.  There 
were  ten  of  each  size. 

The  blocks  to  be  heated  were  kept  in  a  bed 
of  sand  in  a  copper  drying-oven,  into  the  roof 
of  which  a  thermometer  was  inserted — held 
by  a  cork — which  reached  to  the  bed  of  sand 
and  recorded  its  temperature.  The  oven  was 
heated  over  a  Bunsen  burner,  and  could  be 
maintained  at  an  accuracy  of  tw-o  degrees 
Centigrade  range,  which  was  considered  suffi- 
ciently accurate  for  the  purposes  of  the  experi- 
ment, at  least  in  its  preliminary  stages.  It 
required  a  good  deal  of  attention,  howe\er, 
to  keep  it  at  the  desired  temperature.  The 
blocks  to  be  cooled  were  placed  likewise  on  a 
bed  of  sand,  in  a  hea\"y  zinc  bo.x  which  rested 
on  a  wooden  rack,  beneath  which  broken-up 
ice  was  placed.  The  box  was  also  fitted  with 
a  cork  into  which  a  thermometer  was  inserted, 
reaching  to  the  floor  of  sand.  The  accuracy 
of  this  device  likewise  varied  within  two  de- 
grees or  less. 

Before  the  testing  began,  a  rough  attempt 
was  made  to  determine  how  long,  under  the 
conditions  of  the  experiment,  a  block  would 


retain  its  heat.  A  hole  was  made  in  one  of 
the  blocks  so  that  the  bulb  of  a  thermometer 
would  fit  into  it,  and  some  tests  were  made 
with  this  block.  It  was  found  that  in  a  half- 
minute  (which  was  as  long  as  a  block  was  ever 
kept  out  of  the  oven),  of  which  time  it  was 
in  contact  with  the  skin  from  five  to  ten 
seconds,  the  block  lost  less  than  half  a  degree 
Centigrade,  but  that  after  returning  the  block 
to  the  oven  it  was  four  or  five  minutes  before 
the  block  regained  the  oven-temperature. 
Enough  blocks  were  provided  so  that  no  block 
Was  used  oftener  than  once  in  five  minutes, 
and  only  rarely  oftener  than  once  in  seven  or 
eight  minutes. 

It  was  desired  for  the  purposes  of  the  experi- 
ment to  time  the  reactions  in  some  simple 
fashion  that  would  be  suitable  to  use  for  clin- 
ical purposes.  A  stop  watch  could  not  be 
used,  since  both  the  experimenter's  hands  were 
occupied  with  the  blocks;  therefore  a  Thomas 
poKgraph  was  used,  so  arranged  that  the 
experimenter  could  record  the  reactions  with 
her  foot.  A  tambour  was  so  fixed  that  a  light 
tap  upon  it  with  the  experimenter's  toe  was 
transmitted  to  the  writing  lever  of  the  instru- 
ment and  made  a  mark  upon  the  record  paper. 
The  polygraph  was  provided  with  a  Jacquet 
chronograph,  which  marked  fifths  of  a  second. 
Writing  pens  were  used,  thus  obviating  the 
necessity  of  smoked  paper,  and  the  record 
could  therefore  be  marked  permanently-  as  it 
was  made. 

MATERIAL  AND  METHOD 

Five  women  acted  as  subjects  for  the  experi- 
ment. They  included  a  janitress  of  a  flat  and 
a  college  instructor;  they  ranged  in  intelligence 
from  mediocre  to  superior  ability,  and  in  age 
from  twenty-one  to  fifty  years.  They  had  no 
known  nervous  disturbances — except  a  slight 
neuritis  reported  once  by  one  subject — al- 
though one  subject  was  regarded  as  of  a 
nervous  temperament. 

These  five  subjects  were  tested  on  forty 
test  spots  previously  determined,  each  area 
being  tested  four  times  with  the  double  stimu- 
lus— both  cold  and  hot.  An  enumeration  of 
the  spots  follows: 

Area  i. — Fingers  of  right  hand,  dorsal  sur- 
face.   Area  covered  by  two  small  blocks  (held 


Temperature  Sensitivity 


131 


with  the  long  sides  juxtaposed  and  the  long 
axes  running  in  a  radio-ulnar  direction)  on  the 
index  and  middle  fingers,  closely  peripheral  to 
the  metacarpal  bones. 

Area  2. — Fingers  of  left  hand,  dorsal  sur- 
face.   Same  area. 

Area  ^. — Right  hand,  dorsal  surface.  Area 
covered  by  two  small  blocks  (held  in  same 
position)  immediately  proximal  to  second  and 
third  metacarpal  bones. 

Area  4. — Left  hand,  dorsal  surface.  Same 
area. 

Areas. — Right  forearm,  dorsal  surface. 
Area  covered  by  two  large  blocks  (held  with 
the  short  sides  in  juxtaposition  and  the  long 
axes  running  in  a  peripherocentrad  direction) 
which  were  set  down  proximally  to  a  line 
drawn  in  a  radio-ulnar  direction  one  inch 
above  the  protuberance  of  the  ulna,  the  long 
axis  of  the  blocks  coinciding  with  a  line  inter- 
secting the  first  at  right  angles,  one  inch  radiad 
to  the  protuberance  of  the  ulna. 

Area  6. — Left  forearm,  dorsal  surface.  Same 
area. 

Area  7. — Right  arm,  lateral  surface.  Area 
covered  by  two  large  blocks  (held  with  the 
long  sides  juxtaposed  and  the  long  axis  at 
right  angles  to  the  axis  of  the  arm)  which  were 
set  down  proximally  to  a  line  drawn  two  inches 
above  the  olecranon  process  of  the  ulna,  the 
short  axis  of  the  blocks  coinciding  with  a  line 
joining  the  olecranon  process  of  the  ulna  and 
the  acromion  process  of  the  scapula. 

Area  8. — Left  arm,  lateral  surface.  Same 
area. 

Area  11. — Fingers  of  right  hand,  ventral 
surface.    Area  corresponding  to  that  of  Area  i . 

Area  is. — Fingers  of  left  hand,  ventral  sur- 
face.   Same  area. 

Area  13. — Right  hand,  palm.  Area  corre- 
sponding to  that  of  Area  3. 

Area  14. — Left  hand,  palm.    Same  area. 

Area  iS- — Right  forearm,  ventral  surface. 
Area  corresponding  to  that  of  Area  5,  but 
measured  from  protuberance  of  radius. 

Area  16. — Left  forearm,  ventral  surface. 
Same  area. 

Area  17. — Right  arm,  mesial  surface.  Area 
covered  by  two  large  blocks  (held  as  for 
Area  7)  which  were  set  down  proximally  to  a 
transverse  line  one  inch  above  the  crease  made 


by  bending  the  elbow,  the  short  axis  corre- 
sponding with  the  line  of  the  biceps.  The  lat- 
ter line  was  measured  from  the  inner  condyle 
of  the  humerus,  and  the  distance  varied  with 
the  different  subjects  but  remained  the  same 
for  any  one  subject  throughout  the  experi- 
ment. 

Area  iS. — Left  arm,  ventral  surface.  Same 
area. 

Area  ig. — Face,  middle  of  forehead.  Area 
covered  by  two  small  blocks  (held  with  the 
long  sides  juxtaposed  and  the  short  axis  in  a 
cephalocaudad  direction),  set  down  so  as  just 
to  clear  the  eyebrows. 

Area  20. — Dorsal  surface  of  neck.  Area 
covered  by  two  small  blocks  (held  as  for 
Area  19),  set  down  in  the  median  line,  just 
below  the  hair. 

Area  21. — Face,  right  cheek.  Area  covered 
by  two  small  blocks  (held  as  for  Area  19),  set 
down  between  the  hair  and  the  point  of  at- 
tachment of  the  lobe  of  the  ear,  just  in  front 
of  the  tragus. 

Area  22. — Face,  left  cheek.    Same  area. 

Area  2j. — Right  leg,  lateral  surface.  Area 
covered  by  two  large  blocks  (held  with  the 
short  sides  in  juxtaposition  and  the  long  axis 
in  a  cephalocaudad  direction)  which  were  set 
down  proximally  to  a  line  drawn  transversely 
three  inches  above  the  external  malleolus,  the 
long  axis  of  the  blocks  coinciding  with  a  line 
intersecting  the  first  at  right  angles,  drawn 
upward  from  the  same  point. 

Area  24. — Left  leg,  lateral  surface.  Same 
area. 

Area  25. — Right  leg,  mesial  surface.  Area 
corresponding  to  that  of  Area  24,  measured 
from  the  internal  malleolus. 

Area  26. — Left  leg,  mesial  surface.  Same 
area. 

Area  27. — Right  thigh,  lateral  surface.  Area 
covered  by  two  large  blocks  (held  with  the 
long  sides  juxtaposed  and  the  short  axis  in 
a  cephalocaudad  direction),  which  were  set 
down  proximally  to  a  line  drawn  transversely 
three  inches  above  the  outer  condyle  of  the 
femur,  the  short  axis  of  the  blocks  coinciding 
with  a  line  drawn  upward  longitudinally  from 
the  same  point. 

Area  28. — Left  thigh,  lateral  surface.    Same 


132 


Temperature  Sensitivity 


Area2Q. — Right  thigh,  mesial  surface.  Area 
corresponding  to  that  of  Area  27,  measured 
from  two  inches  above  the  inner  cond\le  of 
the  femur. 

Area  30. — Left  thigh,  mesial  surface.  Same 
area. 

Area  31. — Right  foot,  sole.  Area  covered 
by  t\vo  small  blocks  (held  with  the  long  sides 
juxtaposed  and  the  long  axis  running  trans- 
versely), set  down  at  the  intersection  of  two 
lines — a  longitudinal  line  from  the  middle  of 
the  cur\-e  of  the  heel  to  the  junction  of  the 
second  and  third  toes,  and  a  transverse  line 
bisecting  this. 

Area  32. — Left  foot,  sole.    Same  area. 
Area  31. i. — Right  foot,  dorsal  surface.  Area 
covered  by  two  small  blocks  (held  as  for  Area 
31),   set  down   proximally   to   the   third   and 
fourth  toes. 

Area  32.1. — Left  foot,  dorsal  surface.  Same 
area. 

Area  3^. — Abdomen,  median  line,  caudad 
to  navel.  Area  covered  by  two  large  blocks 
(held  with  the  long  sides  juxtaposed  and  the 
long  axis  in  a  transverse  direction),  set  down 
immediately  caudad  to  the  navel. 

Area  34. — Abdomen,  median  line,  immedi- 
ately cephalad  to  navel. 

Area  35. — Abdomen,  right  side.  Area  covered 
by  two  large  blocks  (held  as  for  Area  33), 
set  down  at  the  intersection  of  a  transverse 
line  at  the  level  of  the  navel  and  a  longitudinal 
line  three  inches  to  the  right  of  navel. 

Area  36. — Abdomen,  left  side.  Same  area. 
Area  37.— Back,  median  line.  Area  covered 
by  two  large  blocks  (held  with  the  long  sides 
juxtaposed  and  the  long  axis  running  trans- 
versely), set  down  caudad  to  a  transverse 
line  at  the  level  of  the  lowest  rib,  the  short 
axis  of  the  blocks  coinciding  with  the  line  of 
the  vertebrae. 

Area  38. — Back,  median  line.  Area  covered 
by  two  large  blocks  (held  as  for  Area  37),  set 
down  cephalad  to  a  transverse  line  four  inches 
cephalad  to  the  level  of  the  lowest  rib.  (In  the 
case  of  Subject  G  six  inches  was  used  instead 
of  four.) 

Area  39. — Back,  right  side.  Area  covered 
by  two  large  blocks  (held  as  for  Area  37),  set 
down  at  the  intersection  of  the  line  at  the 


k\c'l  of  the  lowest  rib  and  a  longitudinal  line 
four  inches  lateral  to  the  s[)incs  of  the  v'er- 
tebra\ 

Area  40. — Back,  left  side.    Same  area. 

These  forty  areas  were  tested  four  times  for 
each  individual,  twice  with  the  hot  block 
above  the  cold  {i.  c,  proximal  or  cephalad  to 
it),  and  t%vice  with  the  hot  block  below  the 
cold  {i.  e.,  distal  or  caudad  to  it).  The  two 
positions  are  referred  to  as  Positions  A  and  B 
respectively.  Twenty-six  of  the  areas  were 
also  stimulated  with  two  cold  and  two  hot 
blocks,  separately. 

The  experiment  was  divided  into  two  series, 
each  consisting  of  sixty-six  stimulations,  forty 
with  the  double  stimulus,  thirteen  with  hot 
and  thirteen  with  cold.  The  series  were  ar- 
ranged in  as  nearly  a  haphazard  order  as  was 
possible.  Certain  limitations  were  necessary, 
howe\er,  in  order  to  make  the  experiment  go 
smoothly.  It  was  necessary,  for  example,  to 
restrict  the  region  tested  in  any  group  of  stim- 
ulations to  a  part  of  the  body  that  could  be 
reached  when  the  subject  was  lying  in  one 
position;  it  was  not  permitted  to  test  the  same 
area  twice  without  a  lapse  of  at  least  three 
stimulations  between  (to  avoid  disturbance 
from  after-images);  the  hot  and  cold,  large 
and  small  blocks  had  to  be  so  distributed  that 
no  block  was  used  oftener  than  once  in  five 
minutes,  etc.  The  series  finally  took  form  as 
follows: 

SERIES  I 

Double  Stimltlations  given  in  Position  A 
Group  I.    Right  Arm  and  Hand 


!ST 

AREA 

BLOCKS 

I 

II 

cold 

S   1,2 

2 

5 

— 

La,  I 

3 

3 

hot 

S  a,  b 

4 

17 

cold 

L2,3 

5 

11 

— 

Sc,  3 

6 

15 

hot 

Lb,c 

7 

13 

— 

Sd,4 

8 

3 

— 

Se,  5 

9 

17 

— 

Ld,4 

[Q 

5 

hot 

Le,  a 

II 

I 

— 

S  a,  I 

[2 

15 

— 

Lb,  5 

Temperature  Sensitivity  133 

the  latter  on  the  first  and  third.  Practice 
tests  were  given  to  each  subject  before  each 
group,  on  the  areas  included  in  the  group,  and 
the  arrangement  of  the  series  was  such  as  to 
distribute  as  evenly  as  possible  the  effects  of 
practice. 

Group  5.    Left  Arm  and  Hand 

TEST     ARE.\  BLOCKS 

55  16    cold       L  4.  5 

56  i8    —        L  a,  I 

57  4    —        S  a,  2 

58  6    cold       L  2,  3 

59  2    —        S  b,  3 

60  12    —        S  c,  4 

61  14    —        S  d,  5 

62  18    hot        L  b,  c 

63  4     hot        S  e,  a 

64  16    —        L  d,  4 

65  12    cold       S  I,  2 

66  6    —        L  e,  5 


Double  Stimulations  given  in  Position  B 

Group  I.    Left  Arm  and  Hand 

test  area  blocks 

1  6  —  L  a,  I 

2  18  —  Lb,  2 

3  16  hot  L  c,  d 

4  12  —  S  a,  I 

5  2  —  S  b,  2 

6  4  cold  S  3, 4 

7  14  —  S  c,  5 

8  18  cold  L  3,  4 

9  12  hot  S  d,  e 

10  16  —  L  e,  5 

11  6  hot  L  a,  b 

12  4  —  S  a,  I 

Group  2.  Back,  Neck,  Lateral  Surfaces  of  Arms 

TEST  AREA  BLOCKS 

13  40  hot  L  c,  d 

14  8  —  L  e,  I 

15  38  —  La,  2 

16  7  cold  L  3,  4 

17  39  —  L  b,  5 

18  20  hot  S  b,  c 

19  8  hot  L  c,  d 

20  40  —  L  e,  I 
Series  I  was  given  to  three  subjects  on  the                 21  37  —  L  a,  2 

first  and  third  daj's,  and  to  two  on  the  second                  22  39  cold  L  3,  4 

and  fourth;  while  Series  II  was  given  to  the                 23  7  —  L  b,  5 

former  on  the  second  and  fourth  days  ^nd  to                 24  20  —  S  d,  2 


G 

roup  2.    i 

■Ibdomen 

and  Face 

TEST 

AREA 

BLOCKS 

13 

35 

— 

L  1,2 

14 

34 

— 

Lc,  3 

15 

21 

— 

S  b,  2 

16 

36 

— 

Ld,e 

17 

19 

— 

Sc,  3 

18 

22 

hot 

S  d,e 

19 

33 

— 

L  a,  4 

20 

35 

— 

Lb,  5 

21 

21 

hot 

S  a,  b 

22 

19 

cold 

S4.  5 

23 

36 

— 

Lc,  I 

24 

22 

— 

S  c,  I 

Group  J 

.    Legs  and  Feet 

TEST 

AREA 

BLOCKS 

25 

25 

— 

Ld,2 

26 

28 

— 

Le,3 

27 

30 

— 

La,  4 

28 

24 

— 

Lb,  5 

29 

31 

hot 

Sd,e 

30 

32.1 

— 

S  a,  2 

31 

23 

— 

Lc,  I 

32 

32 

— 

Sb,3 

33 

29 

cold 

L2,3 

34 

26 

— 

Ld,4 

35 

27 

— 

Le,5  ■ 

36 

3I-I 

— 

S  c,  4 

37 

32 

cold 

S5,  I 

38 

31 

— 

S  d,  2 

39 

24 

hot 

La,  b 

40 

23 

cold 

L  I,  2 

41 

29 

— 

Lc,3 

42 

30 

hot 

Ld,e 

Group  4. 

Back,  Neck,  Lateral  Surface  of  Arms 

TEST 

AREA 

BLOCKS 

43 

39 

— 

L  a,  4 

44 

40 

cold 

L5,  I 

45 

8 

— 

Lb,  2 

46 

38 

— 

Lc,  3 

47 

7 

hot 

Ld,e 

48 

20 

— 

S  d,4 

49 

37 

— 

L  a,  4 

50 

8 

cold 

L5,  1 

51 

40 

— 

Lb,  2 

52 

7 

— 

Lc,  3 

53 

39 

hot 

Ld,e 

54 

20 

cold 

S5-I 

134 


Temperature  Sensitivity 


Group  3 

.    Legs  and  Feet 

TEST 

AREA 

BLOCKS 

25 

29 

— 

Lc.  1 

26 

23 

— 

Ld,  2 

27 

31 

cold 

S3.  4 

28 

32 

hot 

S  e,  a 

29 

30 

cold 

L3.4 

30 

26 

— 

Le.  5 

31 

29 

hot 

La,  b 

32 

32.1 

— 

S  b,  5 

33 

27 

— 

Lc.  I 

34 

25 

— 

Ld,2 

35 

3I-I 

— 

S  c,  I 

36 

31 

— 

S   d,2 

37 

24 

cold 

L3.4 

38 

32 

— 

S  e,  3 

39 

2S 

— 

Le,  5 

40 

23 

hot 

La,  b 

41 

30 

— 

Lc,  I 

42 

24 

— 

Ld,  2 

Group  4. 

Abdomen 

and  Face 

TEST 

AREA 

BLOCKS 

45 

35 

hot 

Le,  a 

44 

19 

— 

Se,  3 

45 

33 

— 

Lb.  3 

46 

21 

— 

Sa.4 

47 

36 

— 

Lc,4 

48 

22 

cold 

S  5.  I 

49 

34 

— 

Ld.  5 

50 

19 

hot 

S  b,  c 

51 

35 

— 

Le,  I 

52 

21 

cold 

S2,  3 

53 

36 

cold 

L2,3 

54 

22 

— 

Sd,4 

Group  j.    Right  Arm 

and  Hand 

TEST 

AREA 

BLOCKS 

55 

13 

— 

Se,  5 

56 

15 

cold 

L4.5 

57 

3 

— 

S  a,  I 

58 

17 

hot 

La.  b 

59 

I 

— 

S  b,  2 

60 

II 

— 

Sc,  3 

61 

15 

— 

Lc,  I 

62 

5 

— 

Ld.  2 

63 

3 

cold 

S4.  5 

64 

17 

— 

Le,  3 

65 

II 

hot 

S  d,  e 

66 

5 

cold 

L4,5 

The  temperature  of  the  hot  stimulus  was 
40°-42°  C;  that  of  the  cold  stimulus  was 
i8°-20°.  A  few  variations  beyond  these 
limits  are  noted  in  the  individual  records  of 


Table  l.  The  room  temperature  varie.J  from 
21°  to  24°.  This  temperature,  somewhat 
higher  than  ordinary-  room  temperature,  wis 
chosen  because  it  was  desired  to  keep  the  part 
of  the  body  tested  exposed.  However,  even 
this  temperature  was  not  comfortable  for  most 
subjects,  and  the  covered  parts  of  the  body 
were  not  generally  exposed  for  more  than  five 
minutes  before  they  were  tested.  They  were 
kept  uncovered  throughout  the  test  of  any 
region. 

PROCEDURE 

The  subject  lay  on  a  cot  in  such  a  position 
that  the  experimenter,  standing  beside  her 
with  one  foot  over  the  tambour  used  to  record 
the  reaction,  could,  with  very  little  movement, 
take  the  blocks  from  their  resting  places  and 
set  them  down  on  the  part  to  be  tested.  The 
subject  was  instructed  somewhat  as  follows: 
"I  am  going  to  perform  an  experiment  to  see 
how  you  respond  to  hot  and  cold.  \\'hen  I 
put  this  little  block  down  on  your  hand,  I 
want  you  to  tell  me  just  as  quickly  as  you  can 
what  you  feel.  Tr>'  it  now"  .  .  .  (Se\-eral 
trials,  either  stimulus.)  "Xow  I'll  put  both 
of  them  on  you,  and  you  tell  me  which  you 
feel  first,  just  as  soon  as  you  feel  it;  and  then 
tell  me  just  as  soon  as  you  feel  the  other. 
Close  your  eyes.  Ready,  on  your  arm!" 
Several  trials  were  gi%"en,  until  S  understood 
that  she  was  to  respxmd  as  soon  as  she  felt 
anything.  Some  practice  was  required  before 
S  was  able  to  respond  with  certainty'  on  the 
first  day,  but  thereafter  there  was  rarely  any 
difficulty^  The  directions  were  summed  up, 
after  S  felt  fairly  sure  of  her  replies:  "Xow  you 
see  what  I  am  going  to  do.  Sometimes  you 
will  feel  both,  and  sometimes  you  will  fee!  only 
one  or  the  other,  so  you  must  pay  close  atten- 
tion and  answer  what  you  feel  just  as  soon  as 
you  feel  anything."  S  then  closed  her  eyes, 
the  area  to  be  tested  was  named;  E  removed 
the  blocks  from  their  boxes,  started  the  poly- 
graph, gave  a  ready  signal,  and  set  the  blocks 
down,  simultaneously  tapping  with  her  foot 
upon  the  tambour  which  operated  the  writing 
lever  of  the  polygraph.  S's  responses  were 
likewise  recorded  by  a  tap  of  E's  foot,  the 
blocks  were  returned  to  their  bo.xes,  the 
number  of  the  test  and  S's  verbal  response 
(whether    "cold-hot,"    "hot-cold,"    "cold,"    or 


Temperature  Sensitivity 


135 


"hot")  were  noted  beside  the  drum  record  of 
the  reaction-time,  and  the  second  area  was 
then  tested  in  the  same  way.  A  sample  of 
the  record  paper  is  reproduced  below. 


k'         ?f^  c/^T  ff 


If  the  double  stimulus  was  given  and  both 
cold  and  hot  were  reported,  the  stimulus  was 
immediately  removed.  If  both  were  given  and 
only  one  reported,  the  stimulus  was  left  in 
contact  about  fi\e  seconds  and  then  removed. 
This  same  procedure  was  followed  when  only 
one  stimulus  was  given,  so  that  S's  replies 
could  not  be  controlled  by  knowledge  of  her 
errors. 

If  for  any  reason  the  record  for  any  test 
was  unsatisfactory — if  the  ink  flowed  too 
freely  and  blurred,  if  the  tambour  failed  to 
record,  if  E  was  conscious  of  having  bungled 
and  given  the  stimulus  badly,  as  occasion- 
ally happened — the  test  was  repeated  at  the 
end  of  the  group  in  which  it  occurred,  with- 
out S's  knowledge  of  its  being  a  repeti- 
tion. 

When  the  record  was  completed,  it  was 
scored  by  counting  the  time  marks  between 
the  moment  of  stimulation  and  the  first 
response,  and  between  the  latter  and  the 
second  response.  To  do  this,  lines  were  ruled 
from  the  rise  of  the  recording  mark  to  the 
time  line  by  means  of  a  straight  edge.  Read- 
ings were  taken  to  the  nearest  tenth  of  a 
second. 

CONDITIONS  AFFECTING  RESULTS 

The  reaction-time  to  cold  has  generally  been 
found  to  be  quicker  than  that  to  hot — a  fact 
that  corresponds  to  the  probably  deeper  situa- 
tion of  the  warm  end-organs  below  the  skin 
surface.  It  would  therefore  be  assumed  that 
if  both  stimuli  were  applied  at  the  same  time, 
other  things  being  equal,  the  reaction  to  cold 
would  precede  that  to  hot.  My  results  show 
that    in    most    cases    this    is    what    happens 


{v.  Table  i),  but  the  majority  is  in  some  cases 
so  slight  that  it  is  important  to  consider  the 
"other  things." 

Limitations  of  Method. — In  the  first 
place,  the  limitations  of  the  method  must  be 
taken  into  account.  The  method  of  measuring 
the  reaction  itself  has  a  considerable  possibility 
of  error.  The  simultaneity  with  which  E  ac- 
tually sets  down  the  blocks  and  taps  with  her 
toe  upon  the  recording  tambour  may  be  ques- 
tioned. The  error  might  be  quite  large  in  this 
case,  for  it  is  a  fairly  complicated  procedure; 
nevertheless,  I  think  the  general  consistency 
of  each  individual's  responses  (which  may  be 
seen  from  a  glance  at  Figure  4)  justifies  the 
assumption  that  as  a  matter  of  fact  this  error 
was  not  large  enough  to  afifect  the  results 
materially.  Then  the  recording  of  the  sub- 
ject's responses  by  E  is  also  subject  to  a  slight 
variable  error;  but  this  would  undoubtedly 
be  less — since  E  was  practised  before  she  began 
the  tests — than  the  error  of  unpractised  sub- 
jects in  recording  their  own  responses  by 
unfamiliar  means.  The  method  of  reading  the 
record  is  also  susceptible  of  a  certain  amount 
of  error,  which  would  not  be  greater  in  any 
case  than  one-tenth  of  a  second.  A  more 
serious  source  of  error,  however,  in  the  judg- 
ment of  the  experimenter,  is  the  possibility 
of  a  slight  inaccuracy  in  setting  the  blocks 
down  exactly  together  and  with  equal  pres- 
sure. An  attempt  was  made  to  control  this 
error  by  providing  a  tambour  to  be  attached 
to  the  blocks,  which  would  trace  on  the  record 
the  moment  at  which  each  block  made  con- 
tact with  the  skin.  This  device  could  not, 
however,  be  made  to  work  satisfactorily.  Con- 
sequently when  the  experimenter  recognized 
that  she  had  made  a  distinctly  bad  stimula- 
tion, she  sometimes  repeated  it  to  see  what 
the  result  would  be.  Sometimes  also  when  the 
response  was  given  in  the  order  "hot-cold," 
the  experimenter  repeated  the  stimulus  even 
though  she  thought  it  had  been  given  ac- 
curately. This  was  not  done  systematically 
because  it  would  have  lengthened  the  experi- 
ment too  much;  but  the  following  is  a  sum- 
mary of  the  total  number  of  times  a  test 
was  repeated  which  first  gave  the  response 
"hot-cold." 


136 


Temperature  Sensitivity 


First  Response  "Hot-Cold" 

1st  Badly  Given    ist  Not  Badly  Given 


2ND  RESPONSE 

2ND  RESPONSE 

Subject 

C— H  H— C 

C— H  H— C 

G. 

7           ■ 

I           — 

Co.* 

I          I 

13          8 

K. 

—        — 

—        — 

H.t 

I        — 

4          I 

CI. 

—              2 

6          5 

*  One  response  was  "cold"  only.  In  one  test  that  gave 
the  response  H — C,  E  thought  that  the  cold  block  touched 
first,  but  this  test  was  not  repeated. 

t  One  response  was  "hot"  only. 

Of  twelve  tests  badly  given  and  repeated, 
nine  gave  the  response  C-H,  and  three  H-C 
on  the  repetition.  Of  thirty-eight  tests  re- 
peated, though  not  consciously  badly  given, 
twent>'-four  gave  the  response  C-H,  and 
fourteen  H-C  on  the  repetition.  This  would 
seem  to  indicate  that  while  some  of  the 
responses  that  occurred  in  the  order  H-C  may 
have  been  due  to  inaccuracies  of  method  of 
stimulation,  some  of  them  probably  were  not. 
This  source  of  error,  however,  remains  un- 
determined and  probably  considerable. 

Changes  in  Temperature  of  Skin  or 
Stimulus.— In  the  second  place  the  relation 
of  the  skin-temperature  to  the  stimulus-tem- 
perature, and  also  the  actual  stimulus-tem- 
perature, may  have  affected  the  reaction-time 
in  a  variable  way.  Although  the  room  tem- 
perature was  fairly  constant,  the  skin-tem- 
perature of  different  individuals  on  different 
days,  on  different  regions  of  the  body,  prob- 
ably varied  rather  widely.  This  is  very  likely 
one  reason  for  the  greater  constancy  of  the 
reactions  on  the  abdomen  and  back,  which  is 
shown  by  every  figure — a  less  scattered  dis- 
tribution on  these  areas  for  each  individual, 
a  smaller  variation  among  different  indi- 
viduals, and  a  higher  percentage  of  responses 
in  the  order  cold-hot.  For,  of  course,  the  skin- 
temperature  of  the  usually  covered  areas  of 
the  body  varies  less  than  that  of  the  extremi- 
ties and  uncovered  areas.  The  thighs  and 
.the  back  of  the  neck  also  show  a  greater 
constancy  of  response  than  the  hands  and 
feet.  Variability  of  skin-temperature,  then, 
will  account  for  some  of  the  variability  of 
reaction. 


The  variations  in  the  temperature  of  the 
stimulus  constitute  a  possible  source  of  error 
more  difficult  to  determine.  The  hot  stimulus 
varied  for  the  most  part  between  40°  and 
42°  C.  On  three  days,  a  few  tests  were  made 
with  the  oven  temperature  at  42.5°,  one  day 
it  rose  to  43°,  and  one  day  fell  to  38°;  but  if 
the  individual  records  for  those  days  are 
examined,  it  does  not  appear  that  the  general 
character  of  the  results  was  affected  (v. 
Table  i).  The  cold  temperature  varied 
between  18°  and  20°,  except  on  two  occasions 
— once  when  it  was  between  18°  and  16°, 
and  once  between  17°  and  19°. 

The  hot  stimulus  temperature  was  chosen 
because  it  was  desired  to  have  a  temperature 
distinctly  hot,  yet  below  the  threshold  for 
burning.  This  point  of  course  varies;  Neu- 
mann places  it  on  the  average  at  43.5°,  Head 
at  about  50°.  Temperatures  below  40°  fre- 
quently do  not  elicit  a  hot  sensation.  There- 
fore the  limits  were  so  set.  In  a  similar  way, 
a  cold,  distinctly  cold  but  not  painful,  was 
desired.  Crawford  places  the  limit  for  great 
intensity  of  cold  at  15°,  and  a  temperature 
above  20°  is  not  distinctly  cold  to  a  part  of 
the  skin  whose  temperature  is  27° — as  that 
of  hands  and  feet  often  is.  Therefore  a  tem- 
perature of  i8°-i9°  was  considered  best. 

The  reaction-time  depends,  to  some  extent, 
on  the  temperature  of  the  stimulus.  Gold- 
scheider  found  that  for  a  limited  area  of  the 
forearm,  the  mean  reaction-time  to  cold  for 
a  stimulus  of  20°-i9°  was  .377  seconds;  and 
for  I5.5°-I5°,  .278  seconds — a  difference  of  a 
tenth  of  a  second  for  a  range  of  four  degrees. 
He  also  found  that  for  a  stimulus  of  40°,  the 
mean  time  was  .777  seconds;  and  for  44°, 
.585  seconds — a  difference  slightly  less  than 
two-tenths  of  a  second  for  a  range  of  four 
degrees.  Thus  the  variations  in  the  stimulus 
temperature  may  have  affected  the  results 
by  a  few  hundredths  of  a  second,  but  not 
significantly. 

TOPOGR-A.PHY  OF  WAR.M  AND  COLD  SfOTS.^ 

In  the  third  place,  the  number  of  warm  and 
cold  spots  in  the  areas  tested  may  have  been 
unequal,  and  have  given  a  different  emphasis  to 
one  sensation  or  the  other.  This  effect  should 
have  been  neutralized  by  the  procedure  of 
reversing  the  relative  position  of  the  blocks  in 


Temperature  Sensitivity 


137 


alternate  experiments.  Nevertheless,  slight 
discrepancies  in  the  exact  location  of  the  spots 
might  perhaps  have  thrown  a  strongly  reacting 
spot  into  one-half  or  the  other  of  any  area, 
or  one-half  or  the  other  may  have  contained 
a  particularly  sensitive  spot  of  one  kind.  This 
possible  source  of  error  could  not  be  corrected 
without  a  laborious  exploration  of  the  skin  of 
every  subject,  which  would  not  be  worth  while. 
It  might  perhaps  be  inferred  that  some  idio- 
syncrasy of  warm  or  cold  spots  is  responsible 


for  those  occasional  instances  when  one  area 
gave  a  hot-cold  response  in  each  of  the  four 
tests,  or  only  one  reaction  to  each  test. 
Examples  of  this  may  be  seen  in  Table  i : 
Subject  Co.,  Areas  11,  14,  16;  Subject  H, 
Area  31.  It  may  be  noted  that  Area  13  in 
three  subjects  gave  three  responses  in  the 
order  hot-cold. 

These,  then,  are  the  factors  that  are  or  may 
be  present  in  the  results  and  should  be  borne 
in  mind. 


G.  Co. 

I     DI  N   ^I  ^J  1        1    0     III    IV  Y  VII 


nil  III      I  I  I 

©  K  t,  I          I  III!                   I 

U     ¥  i)  1  II  <ID  II  ©  nil    I         i 

II?  i  mil  o      I  r 


"      '/; 
r 


K. 

u  ffl  n  vvi  \n 


I       I 


H. 

Ill  W  V  VI 


pi      I  I    I 

?  II  I  ®         II      I 

?  I         HD   1    ®  I    I    (fli 

I  II    111  I 


I       d) 
II  (D   I    I 
I    I        I 
I       D 


CI. 


I       U       HI    n  Y  VI  Vli 

I  1 

(111  «»  (#      I  f  I 

II  II  II  I  $ 
I     I    *r 

I   I 


Fig.  I.    Distribution  of  Reactions  to  Single  Stimuli— Cold 

Numerals  I-VII  indicate  regions  in  order  as  follows:  right  arm,  left  arm,  head,  right  leg.  left  leg,  abdomen, 
back.  Each  stroke  indicates  time  for  one  reaction  on  the  region  under  which  it  occurs.  Circles  indicate  medians 
for  each  region. 


G. 

1  IV  Y  \[1  Yll 

I 
1 

II  ®  i 

®  I  ®  I  r 


Co. 

11  11 IV  Y  vr 


I  I 


11      I      I    I  r  I 


K 

II    IE  IV  V  Yl 


I     I    I 
I     I 


11   I    II    I    I         I 

r®  II 


I    1  I  I 


I        I 
I 


H 


lY  V  VI 


I    Hi  ®  r  M 
I    1   I   I 


a 

ID    lY    Y  Yl 


Fig   2     Distribution  of  Reactions  to  Single  Stimuli — Hot 


138 


Temperature  Sensitivity 


TABLE  I 

Reaction-Time  (in  Tenths  of  a  Second)  for  all  Double  Stimulations 
Subject  G 

Position  of  stimuli:  Pos.  A,  Experiment  I  and  3;  Pos.  B,  Experiment  2  and  4 
Temperature:  H— Ex.  i,  42°-39.5°  C;  Ex.  2,  40-42;  Ex.  3,  41-42.5;  Ex.  4,  40-42 
C— Ex.  I,  I8°-I9°;  Ex.  2.  18-19;  Ex.  3.  18-19;      Ex.  4.  18-20 

Room — Ex.  I,  21-23°;  Ex.  2,  23-24;  Ex.  3.  24;  Ex.  4,  21-23 

Dates  of  experiment:  March  15,  April  12.  April  18,  May  24,  1917 


Order  C-II 

Order  H-C 

Area 

1st  Inlv. 

2nd  Intv. 

1st  Intv. 

2)id  httv. 

Single  Resp. 

Ex. 

/ 

2      3 

4 

/ 

2      3 

4 

1234 

1234 

1234 

I 

10 

10     12 

8 

5 

4      3 

3 

3 

9 

10     10 

8 

6 

5      4 

4 

5 

ID 

12       9 

9 

4 

.=;       4 

4 

7 

12 

10      9 

8 

4 

4      4 

3 

II 

18 

II 

10 

4 

4 

4 

C13 

13 

10 

10     10" 

9 

4 

3       4" 

3 

14' 

4' 

15 

9 

9     10 

8 

3 

4      4 

3 

17 

II 

9      9 

9 

4 

4       5 

3 

2 

13 

10     II 

9" 

5 

3      4 

3" 

11' 

3' 

4 

12 

12     10" 

10 

4 

3      4" 

4 

9' 

3' 

6 

12 

9     12 

10 

4 

3      4 

3 

8 

10 

9      9 

8 

4 

4      4 

4 

12 

9     II 

8 

6      3 

4 

13 

4 

14 

II       9" 

9 

4      4" 

4 

II               9' 

4             3' 

16 

9 

10      9 

8 

4 

3      4 

3 

18 

9       8 

10 

4      3 

3 

9 

6 

19 

9 

8 

4 

4 

Cio  Cii 

21 

10 

8     10 

8 

4 

7       4 

4 

22 

10 

10 

8 

4 

4 

7 

C9 

20 

10     ID 

II 

6      4 

7 

14 

4 

23 

ID 

8 

II 

7 

12 

3 

Cio 

25 

13 

10      ID 

8 

4 

4      4 

6 

27 

II 

10      8 

9 

5 

4      3 

4 

29 

ID 

9       8 

9 

5 

4      5 

4 

31 

13 

14     10 

II 

4 

4      6 

5 

311 

II       9 

10 

21       4 

6 

H12 

24 

8 

8 

8 

13 

4 

5 

12 

4 

26 

10 

10       8 

9 

4 

7       5 

4 

28 

9 

10       8 

8 

4 

4      4 

5 

30 

10 

10     19 

8 

3 

4      4 

3 

32 

15 

10     10 

10 

5 

4     10 

4 

32.1 

9 

14       9 

II 

4 

4       7 

6 

33 

9 

9       8 

8 

4 

4      4 

4 

34 

10 

10     12 

8 

4 

3       4 

5 

35 

9 

8       9 

9 

4 

4      4 

3 

36 

10 

9     10 

8 

5 

4      3 

3 

37 

10     II 

8 

4      4 

4 

8 

4 

38 

13 

8     10 

!S 

4 

3      4 

3 

39 

12     10 

8 

4      4 

3 

9 

3 

40 

II       9 

10 

7      4 

3 

8 

4 

Temperature  Sensitivity 

TABLE  I  (continued) 

Reaction-Time  for  Double  Stimulations 

Subject  Co. 


139 


Position  of  stimuli:  Pos.  A,  Experiment  i  and  3;  Pos.  B,  Experiment  2  and  4 
Temperature:  H— Ex.  i,  4i°-4i.s°  C;  Ex.  2,  41-41. 5;  Ex.  3.  40-42;  Ex.  4,  40-42 
C— Ex.  I,  18-18.5°;  Ex.  2,  18;  Ex.  3,  18-20;  Ex.  4,  18-20 

Room — Ex.  I,  24°-22°;  Ex.  2,  22-23;      Ex.  3,  21-22;  Ex.  4,  21-22 

Dates  of  experiment:  Marcli  12,  April  17,  May  18,  May  22,  1917 


Ordei 

C-H 

Order  Il-C 

Area 

ISl  1 

ntv. 

2iid  Intv. 

1st  Intv. 

2nd  Intv. 

Single  Resp. 

Ex. 

I 

2 

3 

4 

I 

2 

3 

4 

J 

2 

3 

4 

I 

2 

3 

7 

1234 

I 

16 

12 

10 

II 

3 

4 

5 

3 

?-, 

13" 

21" 

10 

4 

C13H13  C13' 

5 

II 

6 

14 

10 

13* 

4 

4 

4* 

7 

II 

10 

11" 

4 

4 

4" 

II 

14' 

4 

4' 

II 

' 

iS 

17 

12* 

10* 

4 

5 

4* 

4* 

13 

II 

14" 

4 

4" 

15 

16' 

10 

8 

4' 

4 

15 

10 

ID 

4 

4 

14 

II 

6 

4 

17 

15 

10 

II 

10 

1 1 

4 

4 

4 

2 

8 

13" 

II 

4 

4" 

3 

13 

10' 

10 

4' 

4 

10 

14 

4 

4 

21 

8 

C26 

6 

10 

12 

5 

4 

14 

II 

5 

6 

8 

10 

1 1 

11" 

5 

6 

4" 

12' 

10* 

5 

4* 

12 

9 

II 

4 

4 

II 

12* 

6 

4* 

14 

12 

10 

10* 

10 

II 

4 

4* 

4 

16 

12" 

4" 

13 

II 

1 1 

12' 

6 

4 

5 

4' 

18 

10" 

10 

4" 

3 

12 

10 

8' 

7 

12 

4' 

19 

II 

10 

4 

4 

12 

4 

C21 

21 

13 

14 

10 

6 

4 

5 

II 

4 

22 

II 

11" 

9 

6 

4" 

4 

15 

11' 

9 

4' 

20 

I" 

14 

5 

5 

16 

10 

12 

4 

23 

14 

10 

10 

6 

4 

10 

t 

25 

14 

13 

13 

II 

6 

6 

12 

6 

27 

10 

14 

12 

II 

5 

4 

4 

4 

29 

10 

II 

11" 

9 

5 

6 

4" 

4 

12' 

4' 

31 

15 

12 

C21  C12C16 

311 

13 

15 

14 

12 

6 

9 

C20 

24 

13 

t 

4 

C24  C20 

26 

14 

15 

17 

14 

6 

4 

4 

4 

28 

14 

13 

11" 

9 

6 

4 

5" 

3 

12' 

4' 

30 

10" 

10 

4" 

4 

12 

i.S 

10' 

6 

9 

4' 

32 

12 

4 

t 

16 

18 

C13 

32.1 

15* 

24* 

C15H22C14 

33 

10 

10 

4 

6 

18 

13 

7 

14 

34 

19 

12" 

10 

4 

4" 

4 

13 

12' 

6 

6' 

35 

13 

12 

9 

8 

4 

3 

ID 

4 

36 

17 

ID 

9 

6 

4 

3 

16 

4 

37 

ID 

II 

9 

10 

5 

3 

4 

3 

38 

10 

10 

9 

12 

6 

5 

4 

3 

39 

12 

8" 

9 

6 

6" 

4 

II 

11' 

7 

4' 

40 

II 

10 

8 

5 

5 

3 

9 

6 

■  Stimulus  was  repeated  and  gave  reaction  in  tfie  same  order. 

Figures  underlined  indicate  a  reaction  of  "\ 


t  Judgment  uncertain  or  confused, 
n"  instead  of  "hot." 


140 


Temiierature  Scnsiti\ity 

TABLE  I  (continued) 

Reaction-Time  for  Double  Stimulations 

Subject  K 


Position  of  stimuli:  Pos.  A,  Experiment  i  and  3;  Pos.  B,  Experiment  2  and  4 
Temperature:  H— Ex.  i,  4i°-42°  C;  Ex.  2.  41.5-43;  Ex.  3,  43-40;  Ex.  4,  40.5- 
C— Ex.  I,  i8°-i9°;        Ex.  2.  18-18.5;  Ex.  3.  18-19;  Ex.  4,  18-18 
Room — Ex.  I,  23°;  Ex.  2,  22-23;      Ex-  3.  23-24;  Ex.  4.  23 

Dates  of  experiment:  March  19.  March  27,  April  2,  April  3,  1917 


Order  C-H 

Order  II-C 

Area 

1st  Inli: 

?iid  hill'. 

1st  Intv. 

2nd  I 

ttv. 

Single  Resp. 

Ex. 

1 

2 

3 

4 

1 

2 

3 

4 

I 

2 

3 

4 

I 

2 

3 

4 

1234 

I 

14 

10 

12 

4 

3 

4 

10 

6 

3 

16 

18 

5 

3 

13 

4 

5 

13 

15 

3 

3 

9 

10 

5 

3 

7 

8 

4 

22 

21 

14 

6 

7 

3 

II 

10 

II 

6 

3 

9 

5 

B20t 

13 

t 

18 

12 

12 

t 

5 

5 

3 

15 

14 

5 

10 

II 

4 

4 

B13 

17 

II 

12 

8 

5 

6 

4 

B19 

2 

TO 

II 

3 

3 

12 

4 

H13 

4 

14 

6 

16 

14 

14 

5 

4 

4 

6 

10 

4 

9 

10 

4 

4 

B13 

8 

10 

9 

8 

4 

4 

7 

10 

4 

12 

12 

II 

19 

5 

4 

4 

13 

6 

14 

10 

14 

4 

4 

12 

4 

B17 

16 

12 

4 

21 

4 

Bi2Cn 

18 

14 

12 

4 

4 

9 

14 

3 

4 

19 

II 

ID 

3 

3 

1 1 

8 

3 

3 

21 

10 

9 

9 

4 

4 

3 

16 

5 

22 

14 

10 

12 

5 

4 

4 

II 

5 

20 

13 

12 

9 

4 

4 

3 

B30 

23 

II 

4 

12 

12 

4 

4 

B29 

25 

10 

18 

6 

3 

14 

11" 

6 

3" 

B14' 

27 

II 

II 

4 

4 

9 

3 

C8 

29 

13 

9 

8 

12 

5 

4 

4 

3 

31 

18 

4 

28 

18 

5 

6 

B22 

311 

17 

10 

13 

5 

16 

8 

H19 

24 

21 

5 

16 

18 

4 

4 

B28 

26 

22 

9 

10 

4 

4 

4 

B18 

28 

11 

10 

9 

n 

6 

4 

8 

4 

30 

16 

9 

8 

12 

8 

4 

6 

4 

32 

12 

12 

4 

15 

13 

14 

9 

4 

32.1 

14 

II 

II 

5 

7 

6 

H22 

33 

II 

12 

7 

ID 

4 

7 

4 

5 

34 

II 

10 

10 

7 

3 

5 

8 

3 

35 

10 

10 

10 

4 

3 

3 

9 

4 

36 

II 

10 

9 

10 

4 

4 

4 

4 

37 

II 

II 

5 

4 

13 

5 

B37 

38 

II 

9 

10 

9 

4 

4 

3 

4 

39 

13 

10 

8 

10 

3 

4 

4 

4 

*o 

10 

9 

10 

4 

6 

4 

10 

6 

t  No  record — test  omitted. 

t  Reactions  preceded  by  B  are  cases  in  which  subject  declared  the  sensations  to  be  perceived  simLltaneously. 


Temperature  Sensitivity 


14J 


TABLE  I  {conlinued) 

Reaction-Time  for  Double  Stimulations 

Subject  H 


Position  of  stimuli:  Pos.  A,  Experiment  2  and  4;  Pos.  B,  Experiment  i  and  3 

Temperature:  H — Ex.  i,  38°-4i°  C;  Ex.  2,  40-42;      Ex.  3,  40-42;  Ex.  4,  40- 

C — Ex.  I,  18-16°;  Ex.  2,  17-17. 5;  Ex.  3,  17-19;  Ex.  4,  18- 

Roora — Ex.  I,  22-23°;  Ex.  2.  22;  Ex.  3,  21-23;  Ex.  4,  20- 

Dates  of  experiment:  March  13,  April  10,  May  3,  May  15,  1917 


Order  C-II 

Order  II-C 

A  rea 

1st  Intv. 

3nd  Intv. 

/i/  Intv. 

2nd  Intv. 

Single  Resp. 

Ex. 

I 

2 

3 

4 

/ 

2 

J 

4 

I       2      3 

4 

I 

2 

J 

4 

1234 

I 

13 

14 

II 

31 

12 

6 

H17 

3 

13 

12 

7 

12 

14 

6 

C15 

5 

12 

4 

15 

14 

9 

19 

H18 

7 

15 

13 

21 

5 

14 

13 

H28 

II 

18 

16 

6 

4 

14 

3 

H14 

13 

16 

14 

14     12     14 

10 

II 

4 

13 

10 

4 

•5 

30 

H13         H15 

17 

II 

4 

15              13 

6 

13 

H12* 

2 

16 

,5 

19 

21 

H13        H16 

4 

26 

13 

16 

18 

12 

12 

H14 

6 

II 

14 

7 

9 

22     13 

5 

5 

8 

14 

12 

13 

14'" 

5 

4 

7 

6'" 

17' 

10' 

H15" 

12 

12 

12 

8 

15 

14 

17 

22 

7 

14 

15 

12 

6 

5 

18 

12 

C15 

16 

12 

12 

13 

4 

7 

8 

15 

10 

18 

14 

14 

4 

6 

14 

5 

H13 

19 

H 

14 

18 

7 

6 

19 

14 

17 

21 

10 

21 

20 

6 

4 

H) 

14 

8 

22 

II 

14 

6 

14 

15 

6 

H14 

20 

13 

12 

14 

13 

7 

8 

5 

II 

23 

14 

8 

14             16 

4 

9 

H16 

25 

15 

15 

13 

8 

5 

6 

H18 

27 

18 

22 

C13C14H16 

29 

13 

13 

13 

6 

5 

6 

16 

17 

31 

C12C15C18C16 

3I-I 

17 

21 

17 

4 

26 

7 

H19 

24 

12 

14 

14 

14 

9 

6 

13 

8 

26 

16 

19 

17 

19 

5 

4 

6 

5 

28 

13 

12 

17 

5 

6 

5 

C12 

30 

12 

12 

5 

6 

15 

12 

H20 

32 

14 

28 

C11C15         C14 

32.1 

16 

15 

14 

20 

6 

10 

H18 

33 

12 

II 

4 

9 

16 

5 

H16 

34 

II 

13 

11" 

5 

5 

6" 

18' 

5' 

H22 

35 

14 

17 

7 

6 

14 

14 

H16 

36 

12 

II 

14 

14 

5 

4 

4 

5 

37 

II 

12 

12 

II 

6 

■4 

4 

5 

38 

10 

12 

II 

18" 

5 

5 

7 

6" 

10' 

4' 

39 

10 

12 

II 

14" 

4 

5 

5 

6" 

15' 

5' 

40 

13 

II 

>3 

.5 

4 

24 

12 

8 

142 


Temperature  Sensitivity 


TABLE  I  [continued) 

Reaction-Time  for  Double  Stimulations 

Subject  a. 


Position  of  stimuli:  Pos.  A,  Experiment  2  and  4;  Pes.  B,  Experiment  i  and  3 
Temperature:  H— Ex.  i,  40.5°-42°  C;  Ex.  2,  40.5-42;  Ex.  3,  40-42.5;  Ex.  4,  40-42 
C — Ex.  I,  I7.8°-I9°;        Ex.  2,  18-20;      Ex.  3.  18-20;      Ex.  4,  18-20 
Room — Ex.  I,  22''-23°;  Ex.  2.  24-25;      Ex.  3.  21-22;      Ex.  4,  21-22 

Dates  of  experiment:  March  26,  April  23,  May  23  (o.  m.).  May  23  (/>.  m.),  1917 


Order  C-II 

Order  II-C 

Area 

1st  Intv. 

3nd  Intv. 

1st  Intv. 

2nd  Intv. 

Single  Resp. 

Ex. 

I 

2      3 

4 

/ 

2      3 

4 

1234 

I 

2      3 

4 

12      3       4 

I 

9 

7     II 

4 

3       3 

II 

7 

3 

9 

9 

5 

3 

12       9 

24 

4 

5 

7 

7" 

5 

3" 

9'      9       8 

5'     4 

3 

7 

9 

8 

5 

7 

6 

II 

C7 

II 

12 

7" 

10 

3" 

7'    12     10* 

7'     4 

i.-^ 

14 

8       9" 

4 

4      4" 

t'    10* 

t' 

4* 

15 

6      9 

8 

4      4 

3 

H8 

17 

8 

6       8 

8 

4 

3      4 

3 

2 

11"     8 

4"     3 

10'              8* 

4' 

8* 

H8 

4 

10 

6 

9      9*     8 

6      4* 

6 

6 

8 

3 

89               8 

5 

6 

6 

8 

7 

9       8 

7 

4 

4      4 

6 

12 

8       8 

4       5 

8 

4 

C8 

14 

10 

10 

II 

6 

8 

4 

9* 

4* 

16 

9 

9 

4 

4 

8               8 

5 

6 

18 

10      8 

8 

4      4 

4 

ID 

5 

19 

10 

8 

II 

4 

10      7 

4 

4 

21 

8 

9     10 

9 

9 

3       4 

4 

22 

9 

7 

8 

6 

C8           C12 

20 

9 

8       9 

8 

5 

6       5 

4 

23 

12 

8"     9 

8 

5 

8"     6 

15 

8' 

5' 

24 

10 

8     10 

10 

16 

10       8 

6 

27 

9 

8       9 

6 

4 

5       5 

9 

29 

8 

8       8 

8 

4 

5      4 

4 

31 

9 

11       9 

9 

9     II 

C12 

3I-I 

8       8 

10 

15     12 

14 

16 

4 

24 

7       9 

16      7 

9 

4 

C8 

26 

9 

9 

14 

10 

Cio          C8 

28 

10 

7       8 

8 

5 

6       6 

4 

30 

10 

6      9 

8 

4 

4      6 

4 

32 

9     12 

12 

II     16 

II 

15 

14 

32.1 

9 

8       9 

10 

II 

21     28 

12 

33 

8 

10 

7 

3 

4 

3 

9 

4 

34 

9 

8     10 

8 

5 

4      4 

4 

35 

8 

8       9 

8 

4 

3       4 

4 

36 

8 

8     10 

8 

4 

4      6 

4 

37 

8 

9      8 

8 

4 

4       7 

5 

38 

8       8 

7 

6     12 

5 

8 

4 

39 

7 

8       9 

8 

4 

4       5 

5 

5 

40 

8       8 

9 

4      9 

3 

9 

t  Record  could  not  be  read,  but  response  was  in  Order  H — C. 
*  Stimulus  was  repeated  and  gave  reaction  in  the  same  order. 


Temperature  Sensitivity 


H3 


Explanation:  Meaning  of  "Position  of  Stimulus"  is  explained  under  Method.  Under  "Order 
C-H"  are  grouped  those  reactions  that  gave  response  to  cold  first;  under  "Order  H-C,"  those 
that  gave  response  to  hot  first;  under  "Single  Resp."  those  that  gave  either  cold  or  hot  alone, 
each  figure  designated  by  the  appropriate  letter,  "ist  Intv."  means  time  from  stimulus  to 
first  response;  "2nd  Intv.,"  time  from  first  response  to  second  response.  Twice-accented 
figures  indicate  repetitions  of  the  stimulus,  to  which  the  first  response  is  shown  by  once- 
accented  figures.  Conditions  under  which  repetitions  were  made  are  described  under 
Method. 


TABLE  2 

Reaction-Time  (in  Tenths  of  a  Second)  for  Single  Stimulations 
Cold 


Subject 

G. 

Co. 

A'. 

H. 

CI. 

Av.  M. 

V. 

Area 

Seconds 

3 

II 

10 

13 

12 

10 

19 

9 

12 

8 

9 

1.04 

.2 1 

4 

10 

10 

10 

10 

II 

12 

C14 
H8 

II 

9 

10 

1.03 

•07 

II 

8 

9 

8 

II 

II 

9 

12 

12 

8 

8 

.96 

•15 

12 

10 

9 

II 

II 

12 

10 

12 

13 

8 

8 

1.04 

•14 

5 

12 

8 

14 

'3 

10 

15 

12 

II 

8 

9 

1. 12 

.20 

6 

12 

10 

14 

II 

12 

24 

12 

14 

10 

7 

1.28 

.26 

7 

8 

8 

10 

10 

12 

II 

9 

13 

7 

8 

.96 

.16 

8 

10 

10 

10 

12 

13 

8 

10 

12 

8 

8 

1. 01 

■13 

15 

10 

9 

10 

ID 

9 

10 

ID 

12 

8 

9 

•97 

.08 

16 

II 

9 

17 

13 

10 

12 

10 

15 

8 

8 

I-I3 

•24 

17 

10 

10 

II 

10 

10 

9 

II 

13 

6 

6 

.96 

.16 

18 

9 

8 

10 

II 

9 

7 

12 

10 

8 

9 

•93 

.12 

19 

II 

10 

19 

II 

10 

8 

12 

13 

8 

10 

1. 12 

.20 

21 

10 

9 

11 

10 

10 

II 

14 

13 

II 

10 

1.09 

.11 

22 

II 

8 

17 

II 

13 

12 

12 

12 

10 

9 

I-I5 

.16 

20 

9 

12 

12 

14 

II 

9 

II 

13 

10 

9 

1. 10 

•14 

23 

n 

II 

15 

Cii 
H16 

14 

II 

13 

13 

8 

8 

115 

.20 

24 

Cii 
H4 

ID 

12 

14 

C27 
H6 

C12 
H9 

12 

13 

10 

9 

1. 14 

•15 

29 

Cii 
H6 

C8 
H5 

12 

9 

10 

8 

12 

14 

6 

8 

.98 

.21 

30 

10 

10 

9 

II 

10 

10 

14 

12 

7 

8 

1. 01 

•13 

31 

12 

10 

13 

13 

12 

II 

12 

13 

8 

8 

1.12 

.16 

32 

12 

C9 
H4 

14 

15 

18 

15 

12 

13 

10 

10 

1.32 

.20 

35 

ID 

9 

S 

10 

10 

9 

9 

12 

8 

7 

.92 

.11 

36 

9 

C8 
H4 

9 

9 

9 

9 

8 

13 

10 

8 

•94 

.10 

39 

10 

9 

8 

10 

7 

10 

10 

II 

6 

7 

.88 

.14 

40 

12 

9 

8 

9 

14 

17 

13 

10 

7 

9 

1.08 

.26 

144 


Temperature  Sensitivity 


TABLE  2  (continued) 

Reaction-Time  for  Single  Stimulations 

Hoi 


Subject 
Area 


Co. 


K. 


H. 


Av. 

M. 

V. 

Seconds 

.OS 

.18 

.06 

•24 

.10 

.26 

.07 

•24 

.11 

•19 

.11 

•25 

19 


23 

10 

24 

12 

29 

10 

30 

10 

31 

10 

32 

12 

35 

10 

36 

9 

39 

HS 

C4 

40 


14 


4 

9 

10 

II 

II 

13 

12 

17 

I 

9 

10 

12 

10 

10 

9 

15 

2 

9 

9 

9 

9 

12 

II 

12 

5 

9 

II 

15 

12 

12 

II 

10 

6 

9 

8 

II 

10 

10 

ID 

22 

7 

10 

9 

13 

II 

9 

10 

II 

8 

II 

8 

II 

II 

16 

II 

13 

5 

12 

9 

II 

13 

14 

8 

II 

6 

8 

8 

8 

9 

10 

10 

H13 
C6 

14 


16 


21 

9 

14 

12 

10 

17 

13 

10 

12 

12 

16 

25 

15 

14 

8 

10 

10 

II 

H12 

9 

12 

C8 

H13 

9 

12 

C6 

8 

7 

6 

8 

10 

10 

16 

10 

9 

9 

9 

8 

10 

II 

9 

II 

9 

8 

8 

6 

8 

9 

Iio 

9 

C8 

44 


.18 


07 

.20 

94 

•19 

97 

.11 

07 

.22 

01 

-13 

94 

.09 

18 

•25 

03 

.22 

25 

.28 

37 

.28 

14 

.18 

•23 


99 

.09 

99 

■19 

05 

•15 

08 

.16 

TABLE  3 

Proportion  of  Responses  in  Order,  C-H  and  H-C 
Cold— Hot 


Subject 


G. 


Co. 


K. 


H. 


a. 


Xo. 


Xo. 


No. 


No. 


No. 


■  M.V. 


Right  arm 
Left  arm 
Head 
Right  leg 
Left  leg 
Abdomen 
Back 

Average 


28 


94 

13 

34 

14 

45 

83 

15 

38 

15 

47 

75 

10 

59 

II 

62 

88 

19 

80 

13 

52 

96 

12 

48 

14 

59 

100 

IX 

65 

14 

88 

81 

14 

82 

13 

81 

88.1 

55-3 

62 

19 


15 


3S 

21 

57 

53-6 

17.6 

56 

18 

50 

54-8 

11.8 

75 

II 

69 

68.0 

6.0 

46 

22 

88 

70.8 

17.4 

71 

19 

80 

70.8 

14.0 

64 

15 

94 

82.2 

14.6 

83 

14 

87 

82.8 

1.8 

61.9 

75 

69 

Tern 

peratur 

TABLE  3 

Hot- 

e  Scnsith 

continued) 
-Cold 

ity 

145 

Subject 

G. 

Co. 

K. 

H. 

CI. 

No. 

% 

No. 

% 

No. 

% 

No. 

% 

No. 

% 

Av.  %M.V. 

Right  arm 

I 

3 

22 

58 

13 

42 

12 

38 

14 

38 

34.8      13.0 

Left  arm 

6 

17 

23 

59 

12 

38 

9 

27 

16 

44 

37-0     12.0 

Head 

I 

6 

6 

35 

4 

25 

3 

19 

3 

19 

20.8       7.4 

Right  leg 

I 

4 

I 

4 

7 

28 

3 

13 

2 

8 

11-4       7-3 

Left  leg 

I 

4 

7 

28 

7 

29 

I 

4 

2 

8 

14.6      II. I 

Abdomen 

0 

0 

6 

35 

2 

12 

3 

18 

I 

6 

14.2       9.8 

Back 

3 

19 

3 

i8 

2 

12 

3 

17 

2 

13 

15.8       2.6 

Average 

7.6 

33- 

8 

26.6 

19.4 

19.4 

21.4 

Totals 


TABLE  4 

Single  Responses  to  Double  Stimuli 


Subject 

G. 

Co. 

K. 

H. 

CI. 

Totals 

C        II 

C 

H 

C          H 

C 

H 

C 

H 

C        H 

Fingers 

I         — 





—           I 



4 

I 

1 

2          6 

Hand 

—        — 

3 

I 

—        — 

2 

I 

— 

— 

5           2 

Arm 

—        — 

— 

— 

I         — 

— 

8 

I 

I 

2           9 

Face 

3 

I 

— 

—        — 

— 

I 

2 

— 

6           I 

Back  of  neck 

—        — 

— 

— 

—        — 

— 

— 

— 

— 

—        — 

Leg 

I         — 

2 

— 

—        — 

— 

2 

3 

— 

6           2 

Thigh 

—        — 

— 

— 

I         — 

3 

2 

— 

— 

4           2 

Foot 

—           I 

7 

I 

—          2 

7 

2 

I 

— 

15           6 

Abdomen 

—        — 

— 

— 

—        — 

— 

3 

— 

— 

—          3 

Back 

—        — 

— 

— 

—        — 

— 

— 

— 

— 

13  2 


2  3 


12  23 


40  31 


TABLE  5 

Median  Reaction-Time  for  Single  Stimuli — Grouped  by  Subjects 
Cold 


Subject 

G. 

No.  of 

Co. 

No.  of 

A'. 
No.  of 

H. 

No.  of 

a. 

No.  of 

Region 

Med. 

Cases 

P.E: 

Aled. 

Cases 

P.E. 

Med. 

Cases 

P.E. 

Med. 

Cases 

P.E. 

Med. 

Cases  P.E. 

Right  arm 

•9 

II 

.10 

1.05 

12 

.10 

I.O 

12 

■05 

1.2 

12 

•05 

.8 

12       .00 

Left  arm 

I.O 

12 

•05 

I.I 

12 

.10 

I.I5 

12 

.10 

1.2 

n 

.10 

8 

II       .05 

Head 

I.O 

8 

.10 

I-I5 

8 

•15 

1.05 

8 

•05 

1-25 

8 

•05 

I 

0 

8       .05 

Right  leg 

I.I 

4 

.00 

1-3 

5 

•05 

I.I 

6 

.10 

1-3 

6 

•05 

8 

6       .00 

Left  leg 

1.0 

4 

.00 

1-3 

6 

■15 

125 

4 

•25 

1.25 

6 

•05 

I 

0 

5       -05 

Abdomen 

•9 

4 

.00 

•9 

4 

.00 

•9 

4 

.00 

1.05 

4 

•15 

8 

4       .00 

Back 

■95 

4 

•05 

•85 

4 

•05 

•85 

4 

•15 

1.05 

4 

•05 

7 

4       .00 

146 


Temperature  Sensiti\  it\- 

TABLE  5  {conlinued) 

Hot 


Subject  G.  Co.  K.  H.  CI. 

No.  of  No.  of  No.  of  No.  of  No.  of 

Region        Med.  Cases  P.E.    Med.  Cases  P.E.    Med.  Cases  P.E.    Med.  Cases  P.E.    Med.  Cases  P.E. 


Right  arm 

I.O 

12 

.05       I 

I 

8 

.10 

1.0 

12 

•15       I 

2 

12 

.10 

8 

12 

.00 

Left  arm 

•9 

12 

.10       I 

0 

12 

.10 

1.05 

12 

.10       I 

5 

II 

■45 

8 

12 

.00 

Head 

•95 

8 

.10       I 

I 

8 

.10 

•95 

8 

•05       I 

2 

8 

.10 

8 

8 

.00 

Right  leg 

1.0 

6 

.05       I 

3 

6 

.10 

i^i5 

6 

.10       I 

7 

6 

.10        I 

0 

6 

•05 

Left  leg 

1.0 

6 

.10         I 

35 

6 

.10 

1-35 

6 

■25       1 

4 

6 

.20 

95 

6 

•15 

Abdomen 

•95 

4 

.03      I 

0 

4 

•05 

1.0 

3 

.00       I 

2 

4 

.00 

8 

4 

.00 

Back 

1.0 

3 

.00         I 

I 

4 

.00 

I.I 

3 

.20       I 

25 

4 

.05 

9 

3 

.00 

TABLE  6 

Median  Reaction -Time  for  Single  Stimuli — Groiped  by  Regions 


Med. 


Cold 
No.  of  Cases  P.E. 


Hot 
Med.    No.  of  Cases  P.E. 


Hand — dorsal  (Areas  3,  4) 
Hand — ventral  (Areas  11,  12) 
Arm — dorsal  (Areas  5,  6,  7,  8) 
Arm — ventral  (Areas  15,  16,  17,  18) 
Face  (Areas  19,  21,  22) 
Neck — dorsal  (Area  20) 
Leg  (Areas  23,  24) 
Thigh  (Areas  29,  30) 
Abdomen  (Areas  35,  36) 
Back  (Areas  39,  40) 

Note:  The  lack  of  a  complete  total  for  any  region  indicates  that  the  remaining  responses  were  "cold-hot"  or  "hot-cold." 
*  P.E.  in  these  tables  is  really  Q,  the  semi-interquartile  range,  or  the  distance  above  and  below  the  median  that  will 


1.0 

19 

05 

I.I 

20 

•«5 

1.0 

20 

15 

•95 

20 

■15 

1.0 

35 

15 

1.0 

40 

.10 

1.0 

40 

10 

1.0 

39 

.15 

I.I 

30 

10 

1.0 

30 

.20 

I.I 

10 

15 

1.0 

10 

.20 

I-I5 

16 

15 

1.2 

20 

.20 

1.0 

17 

15 

1.05 

20 

.15 

•9 

19 

10 

1.0 

19 

.10 

•9 

20 

10 

I.I 

17 

••15 

include  fifty  per  cent,  of  the  cases. 


TABLE  7 

Median  Reaction -Time  of  H-C  Responses 


Subject 

G. 

Co. 

A-. 

H. 

CI. 

1st 

2nd 

No.  of 

1st 

2nd 

No.  of 

isi     2nd 

No.  of 

1st 

2nd 

No.  of 

1st 

2nd 

.Vo.  of 

Region 

Int. 

Int. 

Cases 

Int. 

Int. 

Cases 

Int.    Int. 

Cases 

Int. 

Int. 

Cases 

Int. 

Int. 

Cases 

Right  arm 

— 

— 

— 

1.2 

•4 

19 

1.2      4 

13 

14 

■95 

12 

■9 

•4 

II 

Left  arm 

1.0 

•35 

6 

I.I 

.5 

20 

i^25    4 

12 

1.6 

1.0 

9 

.8 

■4 

13 

Head 

— 

— 

— 

I.I 

■45 

6 

•95    -4 

4 

14 

.8 

3 

.8 

•4 

5 

Right  leg 

— 

— 

— 

— 

— 

— 

1.2      .4 

7 

1.6 

•9 

3 

— 

— 

— 

Left  leg 

— 

— 

— 

1-3 

•75 

7 

14      .4 

7 

■— 

— 

— 

— 

— 

— 

Abdomen 

— 

— 

— 

1^3 

•5 

6 

—      — 

— 

1.6 

■5 

3 

— 

— 

— 

Back 

.8 

•4 

3 

I.I 

.6 

3 

—      — 

— 

1.2 

•5 

3 

— 

— 

— 

Temperature  Sensitivity 

TABLE  8 

Median  Reaction-Time  for  C-H  Responses — Grouped  by  Subjects 
First  Interval 


H7 


Co. 


K. 


H. 


a. 


Subject  G. 

No.  of  No.  o_f  No.  of  No.  of  No.  of 

Cases  Med.  P.E.     Cases  Med.  P.E.     Cases  Med.  P.E.     Cases  Med.  P.E.     Cases  Med.  P.E. 


Right  arm 

31 

1.0 

Left  arm 

29 

I.O 

Head 

12 

I.O 

Right  leg 

21 

1.0 

Left  leg 

2.1 

I.O 

Abdomen 

16 

.9 

Back 

13 

I.O 

14 


.20 
.20 


19 


1.2 

.20 

13        I.I 

I-,^ 

•15 

14        I.I 

I.O 

■15 

14          I.O 

I.O 

.10 

13         I.O 

Second  Interval 

.8 


•05 


18 

85 

.10 

II 

9 

.05 

22 

8 

•05 

19 

9 

.10 

15 

8 

•05 

14 

8 

.00 

Co. 


K. 


H. 


CI. 


Subject  G. 

No.  of  No.  of  No.  of  No.  of  No.  of 

Cases  Med.  P.E.     Cases  Med.  P.E.     Cases  Med.  P.E.     Cases  Med.  P.E.     Cases  Med.  P.E. 


Right  arm 

Si 

•4 

.00 

13 

•4 

.00 

14 

•4 

.10 

12 

•65 

.40 

21 

4 

•05 

Left  arm 

29 

•4 

•05 

15 

•4 

.00 

15 

•4 

.00 

19 

•7 

.20 

18 

4 

•05 

Head 

12 

•4 

.10 

10 

■45 

■05 

II 

•4 

•05 

12 

•7 

.10 

II 

5 

.10 

Right  leg 

21 

•4 

.10 

19 

.6 

.20 

13 

•4 

•05 

II 

.6 

.20 

22 

8 

•30 

Left  leg 

23 

•4 

•05 

12 

•4 

.00 

14 

•55 

•15 

17 

.6 

.20 

19       I 

0 

•45 

.■\bdomen 

16 

■4 

.00 

II 

•4 

.10 

14 

•4 

•05 

II 

.5 

.10 

15 

•4 

.00 

Back- 

13 

■4 

■05 

14 

•45 

.10 

13 

•4 

.00 

15 

•5 

.10 

14 

5 

.10 

table  9 
Median  Reaction-Time  for  C-H  Responses — Grouped  by  Regions 


Region 


First  htterval 
No.  of  Cases    Med.        P.E. 


Second  Interval 
Med.        P.E. 


Hand — dorsal  (Areas  1-4) 
Hand — ventral  (Areas  11-14) 
Arm — dorsal  (Areas  5-8) 
Arm — ventral  (Areas  15-18) 
Face  (Areas  19,  21,  22) 
Neck — dorsal  (Area  20) 
Leg  (Areas  23-26) 
Thigh  (Areas  27-30) 
Foot  (Areas  31-32. i) 
.\bdomen  (Areas  33-36) 
Back  (Areas  37-40) 

RESULTS 

With  these  precautions  concerning  the  re- 
liabiHty  of  the  method  we  may  consider  the 
results.  Table  i  presents  the  individual 
responses  in  detail  to  double  stimulations 
for    the   forty   areas.     Table"  2   presents  the 


50 

I.I 

15 

•4 

.10 

41 

I.I 

15 

•4 

•05 

50 

1.0 

15 

•4 

.05 

46 

•95 

iS 

•4 

.00 

40 

I.O 

10 

•4 

.10 

16 

I-I5 

20 

■5 

.10 

53 

I.I 

25 

.6 

.20 

71 

I.O 

20 

■4 

•05 

49 

I.I 

20 

.8 

•35 

67 

I.O 

10 

•4 

•05 

69 

I.O 

15 

•4 

•05 

detailed  responses  to  single  stimulations. 
The  first  thing  that  may  be  noticed  in  a 
rapid  inspection  of  Table  i  is  the  considerable 
number  of  responses  that  were  given  in  the 
order  hot-cold.  Table  3  shows  the  proportion 
of  responses  in  each  order  for  each  individual. 


Temperature  Sensitivity 

TABLE  10 

Comparison  of  Reaction  to  Hot  in  Single  and  Double  Stimuli 


Double  Stimulus  C-H  Resp.       Single 
(i.  e.,  Total  Time)  Stimulus 

Med.  P.E.  Med. 


Difference 


Hand — dorsal 

Hand— ventral 

Arm — dorsal 

Arm — ventral 

Face 

Neck — dorsal 

Leg 

Thigh 

Foot 

Abdomen 

Back 


1-5 

•25 

1. 1 

4 

1-5 

•25 

•95 

55 

1-5 

•  15 

I.O 

5 

1-3 

•  15 

I.O 

3 

1-5 

•  15 

I.O 

5 

1-7 

•25 

I.O 

7 

2.0 

•25 

1.2 

8 

1-4 

•  15 

1.05 

35 

2.0 

•30 

1.2 

8 

14 

.20 

I.O 

4 

1.4 

•15 

I.I 

3 

The  averages  show  that  on  the  arms  the 
percentage  of  C-H  responses  is  only  slightly 
greater  than  half — 53.6  per  cent,  and  54.8 
per  cent.,  while  on  the  abdomen  and  back  it 
rises  to  82.2  per  cent,  and  82.8  per  cent,  re- 
spectively. These  relations  do  not  hold 
exactly  among  individuals,  but  a  tendency 
toward  greater  constancy  for  the  latter  regions 
is  shown  by  the  fact  that  on  these  regions,  in 
only  two  cases  does  the  per  cent,  fall  below 
80,  while  on  the  arms  (with  the  exception  of 
Subject  G.,  whose  per  cents,  are  all  high),  no 
case  rises  above  57  per  cent.  As  regards  the 
H-C  responses,  the  highest  percentages  fall 
on  the  arms,  on  the  average,  and  for  all  sub- 
jects except  G.;  but  the  percentages  on 
abdomen  and  back  are  not  significantly 
smaller  than  on  legs.  Individuals  vary 
greatly — from  G.,  who  has  no  higher  than 
19  per  cent,  of  H-C  responses  for  any  region, 
and  no  less  than  81  per  cent,  of  C-H  responses, 
to  Co.,  who  has  as  high  as  59  per  cent,  of  H-C 
responses  for  one  region  and  only  34  per  cent, 
of  C-H  responses  for  another. 

With  these  responses  may  be  compared  the 
cases  in  which  only  one  response  was  made  to 
the  double  stimulus  (Table  4).  It  will  be 
noticed  from  Table  i  that  one  subject,  K, 
sometimes  reported  that  both  sensations  were 
perceived  simultaneously.  This  fact  will  be 
considered  later.  Excluding  these  responses 
of  K.,  we  find  that  there  are  71  instances  (out 
of  about  800  responses)  when  only  one  of  the 


two  stimuli  is  reported  {v.  Table  4).  Of  these, 
40  are  cold  and  31  hot — a  nearly  equal  dis- 
tribution, but  this  is  produced  by  the  responses 
of  one  individual,  H.,  who  gave  23  hot  re- 
sponses: otherwise,  the  balance  is  in  favor  of 
the  cold.  With  the  exception  of  H.'s  responses 
(which  will  be  taken  up  again),  nothing  of  par-  - 
ticular  significance  appears  from  this  table. 
These  responses  are  probably  to  be  explained 
by  lapses  of  attention  or  slight  inequalities  in 
the  stimulus. 

The  facts  of  Table  2  are  more  easily  under- 
stood from  Tables  5  and  6,  and  Figures  i  and 
2,  which  attempt  to  present  graphically  the 
distribution  of  the  reaction-times  to  separate 
cold  and  hot  stimuli.  The  most  striking  thing 
about  the  distribution  is  the  amount  of  over- 
lapping in  the  reaction-times  of  cold  and  hot. 
The  range  in  both  cases  is  about  the  same, 
with  a  slightly  greater  variability  for  hot. 
The  medians  show  no  consistent  difl'erence  for 
the  two  sorts  of  stimuli.  In  20  cases  out  of 
35  {cf.  Table  5),  the  median  cold  reaction  is 
shorter.  In  14  of  these,  it  is  shorter  by  as 
much  as  .1  second,  and  in  9,  by  .2  second  or 
more.  In  10  cases  the  median  for  hot  is 
shorter,  and  in  the  remaining  5  cases  the 
medians  are  the  same.  This  may  be  due  to 
the  rather  rough  method  of  measurement, 
since  other  observers  have  found  a  clearer 
difference;  on  the  other  hand,  if  the  measure- 
ment adequately  represents  the  fact,  it  ex- 
plains, perhaps,  the  rather  large  number  of 


Temperature  Sensitivity 


149 


responses  to  double  stimuli  that  occurred  in 
the  order,  hot-cold.  The  averages  for  the 
individual  areas  {cf.  Table  2)  show  the  reac- 
tion-time for  hot  to  be  greater  than  for  cold 
in  17  out  of  26  cases — a  slightly  greater 
percentage  of  cases  than  appears  from  the 
medians  of  the  grouped  areas  (Table  6), 
although  in  only  8  of  these  instances  was  the 
difference  in  time  as  much  as  .1  second. 

It  is  of  interest  in  passing  to  compare  the 
median  reaction-time  to  cold  and  hot  sep- 
arately (Table  5)  with  the  percentages  of  C-H 
and  H-C  responses  (Table  3),  though  it  must 
be  remembered  that  the  medians  of  Table  5 
are  computed  on  too  few  cases  to  be  very 
reliable.  Still  it  is  rather  curious  that  Sub- 
ject G.,  who  showed  fewest  cases  of  H-C 
responses,  nevertheless  has  more  areas  that 
give  a  shorter  median  reaction  to  hot  than 
any  other  subject — three  cases  out  of  seven. 
A  certain  tendency  toward  consistency  is, 
however,  suggested  by  a  comparison  of 
Tables  3  and  6.  Table  3  shows  the  greatest 
number  of  H-C  responses,  as  well  as  the 
least  number  of  C— H  responses  to  occur  on 
the  arms.  Table  6  shows  that,  with  the 
exception  of  the  back  of  the  hand,  the  other 
areas  on  the  arms  have  less  than  .1  second 
difference  in  the  medians  for  cold  and  hot, 
one  being  greater  for  hot  than  for  cold,  one 
less,  and  one  equal  to  cold.  The  abdomen  and 
back,  on  the  other  hand,  show  .1  and  .2 
second  difference  respectively,  the  median  for 
cold  being  shorter;  and  these  areas  likewise 
have  the  greatest  number  of  C-H  responses. 
This  seems  to  indicate  that  the  distribution 
of  C-H  and  H-C  responses  is  a  real  one  and 
is  not  due  exclusively  to  faults  or  inaccuracies 
in  the  procedure. 

One  other  thing  may  be  noticed  about 
Table  6 — the  instances  of  double  responses  to 
the  single  stimulus.  Some  regions  show  an 
incomplete  total  for  the  group  of  areas  desig- 
nated, and  the  remaining  number  of  responses 
were  either  "cold-hot"  or  "hot-cold."  Fifteen 
such  responses  were  to  cold,  five  to  hot — that 
is,  cold  was  more  often  felt  as  cold-hot  than 
was  hot  felt  as  hot-cold.  (H-C  responses  to 
cold  and  C-H  responses  to  hot  did  not  occur.) 
This  is  probably  another  illustration  of  the 
fact,  often  mentioned,  that  hot  is  a  more  dififi- 


cult,  less  certain  sensation  than  cold;  so  that 
any  change  or  imagined  change  after  cold  is 
apt  to  be  reported  as  hot.  Subject  CI.  so 
explained  to  herself  several  cases  in  which  she 
reported  the  cold  stimulus  as  "cold-hot"  and 
then  immediately  corrected  herself.  (These 
cases,  if  included  in  the  count,  would  further 
increase  the  difference.)  Possibly  the  slight 
change  in  sensation  was  due  to  inexactness  in 
setting  down  the  blocks  simultaneously  and 
with  equal  pressure.  The  greater  number  of 
cold  stimuli  perceived  as  cold-hot  may  also, 
perhaps,  be  in  part  the  effect  of  suggestion — 
more  responses  to  double  stimuli  occurred 
with  cold  first;  therefore  greater  likelihood 
existed  that  hot  would  follow  cold  than  vice 
versa. 

When  we  turn  to  the  double  responses,  the 
hot-cold  responses  to  double  stimuli  are  not 
numerous  enough  to  form  a  very  accurate 
basis  of  comparison  with  the  cold-hot  re- 
sponses. Table  7  shows  the  medians  for  those 
regions  that  have  as  many  as  three  such 
responses.  Of  course  most  of  these  have  a 
high  degree  of  unreliability,  but  no  particular 
differences  from  the  distribution  of  cold-hot 
responses  appear. 

These  responses  may  also  be  compared  with 
the  C-H  responses  in  regard  to  the  length  of 
the  interval  between  the  first  and  second  re- 
sponses. In  order  so  to  compare  them,  the 
ratio  of  the  second  response  to  the  first  was 
determined  for  each  response.  The  distribu- 
tion of  these  ratios  is  presented  in  Figure  3. 
The  medians  for  both  sorts  of  responses  are 
indicated  by  circles  and  crosses  respectively. 
In  twenty-two  cases  there  were  at  least  three 
H-C  responses  for  a  given  region.  Of  these, 
five  are  equal  to  the  median  ratio  for  C-H 
responses  for  that  region,  five  are  less,  and 
twelve  are  greater.  That  is,  when  the  response 
occurred  in  the  order  hot-cold,  there  was  a 
slight  tendency  for  the  second  interval  to  be 
longer  in  relation  to  the  first  than  when  the 
response  occurred  in  the  order  cold-hot.  This 
is  rather  unexpected,  and  may  perhaps  be 
considered  an  intimation  that  in  such  cases 
the  blocks  were  not  applied  quite  simultane- 
ously. 

We  may  turn  now  to  a  study  of  the  cases 
in  which  the  response  was  given  in  the  order 


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152 


Temperature  Sensitivity 


cold-hot  {v.  Tables  8  and  9,  Figures  4  and  5). 
Figure  4  shows  the  distribution  for  each  indi- 
vidual and  brings  out  such  individual  differ- 
ences as  there  are.  Subjects  G.,  Co.,  and  K. 
are  quite  similar  as  to  median  times  and 
distribution;  H.  has  somewhat  longer  times 
and  more  extreme  reactions,  but  a  similar 
difference  in  the  median  time  of  the  two  inter- 
vals; CI.  has  a  curious  distribution,  in  that 
the  median  time  for  the  second  interval  is 
relatively  long — longer  even  than  for  the  first 
interval,  in  one  case.  Four  subjects  show  less 
variability  for  the  second  interval  than  for  the 
first;  that  is,  the  second  interval  follows  the 
first  at  a  fairly  constant  interval  of  about  .4 
second,  whatever  the  length  of  the  first  inter- 
val. In  the  case  of  CI.,  however,  the  reverse 
is  true.  This  accords  with  the  fact  shown  by 
the  distribution  of  ratios  (cf.  Figure  3):  the 
ratio  of  the  second  interval  to  the  first  varies 
more  than  the  second  interval.  Individuals 
vary  least  in  reaction-time  on  abdomen  and 
back  (range  of  medians  for  these  regions,  .8- 
1.2  seconds — cf.  Table  8),  and  most  on  legs 
(range  of  medians,  .8-1.5  seconds). 

The  double  stimulus,  when  cold  is  perceived 
first,  does  not  appear  much  to  affect  the 
reaction-time  to  cold.  Comparing  the  reac- 
tion-time to  cold  in  the  case  of  single  and 
double  stimulations  {cf.  Table  6  and  Table  9), 
we  find  that  three  are  shorter  for  the  double 
than  for  the  single  stimulus,  five  are  longer, 
and  three  are  equal  in  the  two  cases. 

The  effect  on  the  reaction-time  to  hot  is. 


naturally,  to  increase  it.  This  may  be  seen 
by  comparing  the  medians  for  the  total  reac- 
tion-time of  C-H  responses  {i.  e.,  the  time  for 
the  perception  of  hot  in  the  double  stimula- 
tions) with  the  medians  for  the  reaction  to 
hot  separately.  Table  10  presents  the  com- 
parison. 

The  difference  is  about  .4  second,  on  the 
average,  but  it  is  noteworthy  that  on  the  foot, 
leg  and  neck,  the  time  is  considerably  in- 
creased for  the  double  stimulus.  This  increase 
is  due  partly  to  a  delay  in  the  perception  of 
hot  for  those  regions,  as  the  table  shows.  But 
this  is  not  enough  to  explain  the  amount  of 
difference  in  the  reaction  of  these  regions  to 
double  stimulations;  the  greater  delay  in  this 
case  must  be  in  some  way  dependent  on  the 
double  stimulation.  It  is  possible  that  this  is 
occasioned  by  the  phenomenon  referred  to  by 
Alrutz  and  Goldscheider  as  the  Anschwellung 
of  the  sensation — the  increase  in  intensity  of 
the  sensation  immediately  after  the  first  per- 
ception of  it — which  is  certainly  most  notice- 
able on  the  feet  and  legs.  At  this  stage  of  the 
experiment,  however,  nothing  definite  can  be 
said  on  this  point. 

Since  the  purpose  of  this  paper  is  chiefly  to 
present  the  facts  as  they  appeared  from  an 
examination  of  normal  subjects,  the  paper  will 
close  with  a  summary  of  the  individual  cases. 
The  five  individuals  chosen  were  presumably 
normal.  They  were  not  given  a  neurological 
examination,  but  they  were  all  personally 
known  to  the  experimenter. 


TABLE  II 

Summary  of  Individual  Differences 


Total  No.  of  Resp. 

Reactions     Giving     Response     C- 

-H 

Ratio  of  2nd 

Reaction  to 

to  Double  St 

im. 

Reaclions             Range  of 

Areas 

Total 

Intv.  to  1st 

Sing.  Stim. 

Greater             Medians  of 

Having 

Time 

Single  Ratios  Medians    Med.  for 

than         Different  Regions 

less  than 

Greater 

<.2S      >i.o      >.44 

H.  less 

1.4  Sec. 

2  Resp. 

than 
2.S  Sec. 

than  C 

C-H 

H-C 

Sing. 

No.  ofCasesist  Inlv.    2nd  Intv. 

No.  of 
Ca.'ies 

No.  of 
Cases 

No.  of  Cases 

No.  of  Cases 

G. 

144 

13 

5 

4         . 1  sec.       0  sec. 

0 

0 

230 

3 

Co. 

94 

68 

15 

II         .3             .2 

10 

2 

3          5          I 

2 

K. 

92 

47 

5* 

II         .2             .2 

10 

3 

14          2          I 

2 

H. 

97 

34 

35 

37         -3             -25 

9 

17 

4         15         6 

I 

CI. 

120 

39 

10 

7          .1              .6 

3 

4 

0         23          6 

2 

'  Thirteen  cases  were  reported  as  simultaneous 


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Fig.  6.  General  Distribution  of  Responses 
TO  Double  Stimuli;  (a)  Percentage  of 
C-H  Responses;  (6)  Percentage  of  H-C 
Responses;  (c)  Percentage  of  Single 
Responses  to  Double  Stimuli 


Subject  G.  Subject  K. 

Subject  Co.  -.-.  Subject  H. 

^■^^^""  Subject  CI. 


154 


Temperature  Sensitivity 


155 


Subject  G. — A  young  woman  of  about 
twenty-one  years  of  age,  a  student  of 
domestic  science,  without  any  known  nerv- 
ous or  temperamental  abnormalities. 

Compared  with  other  subjects,  G.  showed 
a  greater  constancy  of  reaction  in  every  re- 
spect. All  the  figures  of  distribution  show  a 
close  grouping  of  her  reaction-times — only  four 
instances  in  the  C-H  responses  when  the 
reaction  was  greater  than  1.4  seconds,  only 
eighteen  cases  when  the  hot  reaction  preceded 
the  cold,  five  reactions  in  which  only  one  of 
the  two  stimuli  was  perceived,  scarcely  any 
variation  in  the  median  time  for  different  areas 
for  either  first  or  second  interval — but,  on 
the  other  hand,  three  areas  where  the  median 
for  the  separate  hot  stimulus  was  shorter  than 
the  median  for  cold;  a  close  grouping  of  ratios, 
and  no  individual  area  which  did  not  give  at 
least  two  reactions  in  the  order  cold-hot.  On 
the  whole,  G.  is  rather  an  ideal  illustration  of 
the  norm. 

Subject  Co. — A  woman  of  about  fifty  years  of 
age,  without  any  known  abnormalities. 

The  distribution  of  Co.'s  responses  is  more 
variable  but  shows  the  same  general  charac- 
teristics as  G.'s,  except  in  the  number  of  H-C 
responses.  Seventy  cases  occurred,  most  of 
them  on  the  arm,  hand,  or  foot.  It  is  to  be 
noted  (c/.  Table  i)  that  the  H-C  responses 
that  were  repeated  gave  the  same  kind  of 
response  only  on  arm,  hand,  and  foot — never 
on  other  regions.  It  is  also  noticeable  that 
Area  1 1  gave  no  C-H  responses  but  six  in  the 
order  H-C;  Area  14,  no  C-H  responses  but 
five  H-C;  Areas  3,  31,  and  32.1  gave  three 
single  responses,  and  in  the  case  of  Area  31, 
all  three  were  "cold."  Co.  shows  a  somewhat 
greater  variability  for  different  regions  of  the 
body  than  does  G.,  with  shortest  median 
times  on  abdomen  and  back. 

Subject  K. — A  young  woman  of  about  thirty 
years  of  age,  a  graduate  student  in  psychol- 
ogy— no  abnormalities  known. 

K.  also  shows  the  same  general  form  of  dis- 
tribution, with  an  intermediate  number  of 
forty-seven  H-C  responses.  K.  however, 
reported  thirteen  times  that  the  sensation 
was   simultaneous.      This    is   rather   curious. 


since  it  occurred  in  no  other  subject,  and  it 
was  probably  the  effect  of  suggestion.  K.  had 
heard  a  little  about  the  experiment  before  act- 
ing as  subject,  and  while  she  did  not  know  the 
procedure,  she  evidently  speculated  a  little 
about  it.  Toward  the  end  of  the  second  day 
she  remarked  that  she  supposed  the  blocks 
were  put  down  simultaneously  and  she  felt 
one  before  the  other,  because  she  did  not  per- 
ceive two  contacts!  It  will  be  noticed  from 
Table  i  that  on  the  first  day  no  cases  of  this 
sort  appear.  Nevertheless  K.  appeared  to 
have  some  hesitancy  in  determining  which 
sensation  came  first,  and  it  is  probably  in 
consequence  of  this  that  she  has  fourteen 
ratios  (compared  with  a  small  number  in 
other  subjects)  less  than  .25,  which  indicates 
a  relatively  long  first  interval. 

Subject  H. — A  woman  of  about  forty-five 
years  of  age,  janitress  of  a  flat,  generally  re- 
garded as  of  a  rather  nervous  temperament. 
H.  deviates  somewhat  from  the  general 
distribution  of  the  first  three  subjects.  Her 
reaction-time  is  longer,  and  she  has  more 
extreme  reactions — thirty-seven  of  her  C-H 
responses  are  greater  than  1.4  seconds.  Her 
total  times  are  in  seventeen  instances  greater 
than  2.5  seconds  (compared  with  eight,  the 
maximum  for  any  other  subject).  Her  ratios 
are  also  longer,  fifteen  being  greater  than  i.o, 
and  six  medians  being  more  than  .40-.44,  the 
most  frequent  ratio.  H.  has  thirty-five  cases 
of  a  single  response  to  a  double  stimulus — • 
three  areas  giving  a  single  response  as  many 
as  three  times  out  of  four.  Twenty-three  of 
these  were  hot  and  twelve  cold,  reversing  the 
proportions  of  every  other  subject  but  K., 
in  whom  the  two  sorts  were  practically  equal. 
In  contrast  to  this,  it  will  be  noticed  from 
Table  i,  that  not  infrequently  H.  responded 
by  "warm"  instead  of  "hot,"  although  she  was 
not  asked  to  differentiate.  It  is  true  that  for 
this  subject  on  the  first  day  the  temperature 
of  the  hot  stimulus  fell  to  38°;  however,  most 
of  the  "warm"  responses  did  not  occur  on  this 
day,  and  on  other  days  the  temperature  was 
not  below  40°. 

Subject  Cl. — A  young  woman  of  about  thirty 
years  of  age,  a  graduate  student  in  psychol- 
ogy.   On  the  second  day  Cl.  was  recovering 


156 


Temperature  Sensitivity 


TABLE  12 

Summary  of  Reactions 


Cold- 
Separate 


Hot- 
Separate 


Cold— Hot  Hot— Cold 

Interval      27id  Interval      isl  Interval     2nd  Interval 


II 


III       IV 


V       VI 


VII     VIII       IX       X 


XI     XII 


Fingers 

10 

8-II 

9 

9-12 

Hand 

10 

10-12 

II 

9-12 

Forearm 

10 

9-12 

10 

9-12 

Arm 

10 

S-ll 

10 

8-11 

Face 

II 

10-12 

10 

8-12 

Neck — dorsal 

II 

9-12 

10 

8-12 

Leg 

II 

IO-I3 

12 

10-14 

Thigh 

10 

9-12 

10 

10-12 

Foot 

12 

IO-I3 

12 

11-15 

Abdomen 

9 

S-io 

10 

9-1 1 

Back 

9 

S-io 

II 

9-12 

*  Total  range: 

group 

included  only 

three  cases. 

from  an  attack  of  neuritis 

in  her  left  arm. 

This  does 

not  seem 

to  have  changed  the 

character  of  her 

responses 

for  th 

is  day  or 

for  her  left 

arm 

in  general. 

The  general  character  of  Cl.'s  responses 
shows  quite  individual  characteristics  —  a 
markedly  short  reaction-time  to  hot  and 
cold  separately  and  to  cold  in  the  case  of  the 
double  stimuli,  but  a  delay  in  the  reaction 
to  hot  on  the  legs,  which  made  the  median  for 
hot,  in  the  C-H  responses,  as  long  or  longer 
than  the  median  for  cold.  She  has  few  ex- 
treme reactions,  but  all  of  them  are  to  hot 
stimuli.  Of  the  ten  instances  of  single  reaction 
to  double  stimuli,  only  two  were  "hot."  In 
Figure  2  extreme  reactions  to  hot  separately 
may  be  noted  on  the  left  arm  and  right  leg, 
while  in  Figure  4  nearly  all  the  reactions 
that  are  extreme  occur  on  the  right  and  left 
legs  and  not  at  all  on  the  left  arm.  Her  ratios 
tend  to  be  longer  than  the  others;  six  medians 
are  over  .40-.44,  and  twenty-three  separate 
ratios  are  greater  than  i.o. 

CONCLUSIONS 

In  so  far  as  these  five  subjects  may  be  rep- 
resentative of  the  normal  reaction  to  cold  and 
hot  stimulation  under  the  conditions  of  this 
experiment,  we  may  summarize  the  results  as 
follows: 

I.  More  than  half  of  the  total  number  of 


)     10-12  4      3-  5  12  10-13  54-7 

)     10-14  4       4-  6  12  10-14  44-6 

)       9-12  4       3-4  II  9-14  5     4-  6 

)       8-11  44-5  12  10-14  54-7 

)      9-11  4       4-6  II  10-14  54-6 

>  9-1 1  4       4-6  14  10-16*  4     4-12* 
9-14  6       4-  8  12  10-16  4     4 

)   8-11  4   4-  3  12  12-15  54-9 

10-14  8   5-12  16  15-16  8  5-14 

>  9-11  44-5  13  10-16  54-6 
I   8-11  44-6  10  9-11  5  4-  6 

reactions  to  simultaneous  cold  and  hot  stim- 
ulation elicit  first  cold,  then  hot.  The  back 
and  abdomen  have  a  higher  percentage  than 
other  regions  of  such  responses. 

2.  The  proportion  of  responses  to  double 
stimulation  that  does  not  include  both  re- 
sponses is  small — 8  per  cent,  on  the  average, 
with  a  minimum  of  3  per  cent,  and  a  maximum 
of  20  per  cent. 

3.  The  reaction-time  to  cold  and  hot  stim- 
uli separately  does  not  show  any  distinct 
difference,  as  measured  in  this  way,  except 
perhaps  on  the  abdomen  and  back. 

4.  The  length  of  the  first  interval,  when 
"cold"  is  the  first  response  to  the  double  stim- 
ulation, is  about  1.0  second;  the  length  of  the 
second  interval,  about  .4  second,  on  the 
average.  A  second  interval  of  more  than  i.o 
second  is  rare. 

5.  The  order  in  which  the  response  occurs 
— whether  "cold-hot"  or  "hot-cold" — is  prob- 
ably dependent  in  part  on  the  simultaneity 
of  application  and  in  part  on  physiological 
conditions. 

6.  Individual  differences  in  all  of  these  re- 
spects are  so  considerable  that  a  wide  devia- 
tion from  the  average  must  be  admitted  as 
normal. 

7.  The  method,  though  not  accurate  within 
very  fine  limits,  gives  a  clinical  picture  suffi- 
ciently precise  to  show  individual  differ- 
ences  among   normal    subjects,    and   should 


Temperature  Sensitivity 


157 


TABLE  12 

Summary  of  Reactions 


%  C-H 


%  H-C 


%  Sing. 


%? 


XIII 


XIV 


XV 


XVI 


Fingers 

55.6 

34-6 

8.8 

I.I 

Hand 

47-1 

41-5 

7.8 

3-3 

Forearm 

50.6 

36.1 

6.0 

3.6 

Arm 

58.2 

32.6 

7-4 

1-3 

Face 

65.5 

23-1 

11.4 

— 

Neck — dorsal 

84.2 

15-8 

— 

— 

Leg 

64.6 

18.3 

97 

7.2 

Thigh 

83.1 

9.6 

7.2 

— 

Foot 

61.2 

II. 2 

25.0 

2.4 

Abdomen 

81.7 

14.6 

37 

— 

Back 

83.1 

157 

— 

1.2 

therefore  be  useful  in  dealing  with  abnormal 
cases. 

For  convenience  of  reference,  a  table  sum- 
marizing the  data  is  appended.  The  first 
two  columns  of  the  table  give,  respectively, 
the  median  reaction-time  in  tenths  of  a  second, 
and  the  limits  between  which  50  per  cent,  of 
the  cases  are  included,  for  responses  to  sep- 
arate coW  stimuli.  Columns  I II and IV  give  the 
same  facts  for  separate  hot  stimuli.  Columns 
V-XII  contain  similar  data  for  responses  to 
double  stimuli,  first  for  Cold-Hot,  then  for 
Hot-Cold  reactions,  and  for  each  interval. 
Columns  XIII-XVI  show  the  proportion  of 
double  stimuli  that  gave  responses  of  each 
kind:  C-H, H-C, Cold  orHot  alone, and  Doubt- 
ful (where  the  priority  of  either  could  not  be 
decided). 

If  individuals  are  to  be  compared  with  this 
table,  it  must  be  remembered  that  a  subject's 
median  reaction-time  may  lie  anywhere  within 
the  limits  of  the  probable  error  or  even  slightly 
outside  of  these  limits  and  still  be  normal. 
The  percentage  of  stimuli  giving  any  par- 
ticular sort  of  response  is  even  more  subject 
to  individual  variation.  All  that  it  would  be 
safe  to  say  about  the  normal  reaction  in  this 
respect  is  that  a  majority  of  the  total  responses 
of  an  individual  should  be  Cold-Hot,  though 
on  any  region  except  the  face,  thigh,  abdomen, 
and  back  the  percentage  may  fall  below  fifty; 
and  further,  that  a  very  small  proportion  of 


the  total  will  fail  to  give  both  responses,  and 
that  the  neck,  back,  and  abdomen  are  least 
likely  to  present  this  type.  The  graphs  in 
Figure  6  will  make  this  clear. 

BIBLIOGRAPHY 

1.  Abbot,  Edwina.    19 14,  Effect  of  Adaptation  on 

the  Temperature  Sense,  Psych.  Rev.  Monog., 
xvi.  No.  2. 

2.  Alrutz,  Sydney. 

(a)  1908,  Untersuchungen  iiber  die  Tempera- 
tursinne,  Ztsch.f.  Psychol,  u.  Physiol,  d. 
Sinnesorg.,  47,  p.  161. 

{b)   1900,  Skandin.  Arch.f.  Physiol.,  x,  p.  340. 

(c)  1897,  Notes  on  the  Temperature  Senses, 
Mind,  vi,  p.  445. 

{d)   1898,  The  Sensation  Hot,  Ibid.,  vii,  p.  141. 

3.  Blix,  Magnus.     1884,  Experimentelle  Beitrage 

ziir  Losung  der  Frage  iiber  die  specifische 
Energie  der  Hautnerven,  Ztsch.  f.  Biol.,  N.  S. 
ii,  p.  141  and  N.  S.  iii,  p.  145. 

4.  Crawford,  J.  F.    1898,  A  Study  of  the  Temper- 

ature Sense,  Psych.  Rev.,  5,  p.  63. 

5.  Donaldson,  H.  H.    1885,  On  the  Temperature 

Sense,  Mind,  10,  pp.  399-416. 

6.  DoNATH,  Julius.     1884,  Uber  die  Grenzen  des 

Temperatursinnes  in  gesundem  und  krankem 
Zustande,  Arch.  f.  Psychiat.,  xv,  p.  695. 

7.  Eulenberg,  a.     1885,  Zur  Temperatursinnes- 

messung,  Monatsch.  f.  prakt.  Derm.,  4,  p.  i. 

8.  Franz,  S.  I.     1909,  Sensations  following  Nerve 

Division,  /.  Contp.  Neurol,  and  Psych.,  19, 
pp.  107,  215. 


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Temperature  Sensitivity 


9.   GOLDSCHEIDER,  A. 

(a)  1887,  Eine  neue  Methode  der  Temperatur- 

sinnesprufung,    Arch.   /.    Psychiat.    u. 

Nervenkrankh.,  18,  p.  659. 
{b)   1884,  Die  specifische  Energie  der  Gefuhls- 

nerv'en  der  Haut,   Monatsch.  f.   prakt. 

Dermal.,  3,  Nos.  7,  9,  10. 
(c)    1898,  Physiologie  der  Hautsinnesnerven, 

Gesammelte  Abhandlungen,  vol.  i. 
{d)   1912,   Beitrage  zur  Lehre  der  Hautsen- 

sibilitat,  Zlsch.  /.   klin.   Med.,   75,   pp. 

1-14. 
(e)    1912,  Revision   der   Lehre  vom  Tempe- 

ratursinn,  Ber.  u.  d.  V.  Kong.  f.  exper. 

Psychol.,  Leipzig. 

10.  Holm.     1903,  Die  Dauer  der  Temperaturemp- 

findung  bei  konstanter  Reiztemperatur,  Skan- 
din.  Arch.  f.  Physiol.,  14,  p.  242;  cited  1905, 
in  Nagel's  Handbuch,  iii. 

11.  KiESOW,    Friedrich.      1895,    Untersuchungen 

iiber  Temperaturempfindungen,  Philos.  Stnd., 
xi,  P-  135- 

12.  L.\EHR.     1895-6,  tJber  Storungen  der  Schmerz- 

u.  Temperaturempfindung  in  Folge  von 
Erkranken  des  Riickenmarks,  Arch.  J.  Psy- 
chiat., 28,  pp.  773-874. 

13.  Leegaard,  Chr.    1891,  ijber  eine  Methode  zur 

Bestimmung  des  Temperatursinns  am  Kran- 
kenbett,  Deutsch.  Arch.  f.  klin.  Med.,  48,  p.  207. 

14.  Marinesco,  G.    1905,  Les  troubles  de  la  bares- 

thesie  et  leur  coexistence  avec  panesthesie 
vibratoire,  Semaine  med.,  25,  p.  565. 

15.  Neumann,  Fritz.     1903,  Beitrage  zur  Klinik 

des  Warmesinnes,  Deutsch.  Arch.f.  klin.  Med., 
76,  p.  106. 


16.  NoTHNAGEL.     1866-7,  Beitrage  zur  Physiologie 

und  Pathologie  des  Temperatursinns,  Deutsck- 
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17.  Ranson,   S.   W.      191 5,    Unmyelinated   nerve- 

fibrgs  as  Conductors  of  Protopathic  Sensation, 
Brain,  38,  pp.  381-389. 

18.  Rivers,  W.  H.  R.,  and  Head,  Henry.     1908. 

A  Human  E.Kperiment  in  Nerve  Division, 
Brain,  31,  p.  323. 

19.  SoMMER.      Zahl    der    Temperaturpunkten    der 

ausseren  Haut,  Ber.  d.  Physik.-med.  Gesellsch. 
ZH  Wlirzburg,  Sitz.  von  22  Nov.,  1900. 

20.  Thunberg. 

(a)  1896,  Article  in  Upsala  Ldkaref.  Forh.; 
cited,  1898,  by  Alrutz,  Mind,  p.  143. 

(6)  1901,  Untersuchungen  iiber  die  relative 
Tiefenlage  der  Kalte-,  Warme-,  und 
Schmerzpercipierenden  Nervenenden  in 
der  Haut,  Skandin.  Arch.  f.  Physiol., 
.\i,  p.  382. 

(c)  1905,  Article  in  Nagel's  Handbuch  der 
Physiologie,  iii,  p.  680. 

21.  Trotter  and  Davies.    1913,  The  Peculiarities 

Found  in  Cutaneous  Areas  Supplied  by  Re- 
generating Nerves,  Jour.  f.  Psych,  ic.  Neurol., 
20,  p.  E102. 

22.  Veress,  Elmer.    1902,  Beitriige  zur  Kenntniss 

der  Topographic  der  Warme-Empfindlichkeit, 
Arch.f.  Physiol.,  89,  p.  i. 

23.  VON  Frey,  M.     Beitrage  zur  Physiologie  des 

Schmerzsinns,  Gesellsch.  d.  Wissensck.  z.  Leip- 
zig, 1894,  46;  Pt.  I,  p.  185;  Pt.  2,  p.  283;  ibid., 
1895,  47,  Pt.  3,  p.  166. 

24.  Weber.    1851,  Tastsinn  und  Gemeingefiihle. 


Paul  B.  Hoeber,  67-69  East  S9Iu  Street,  New  York 


A  CONTRIBUTION  TO  THE  STUDY  OF  TEMPERATURE 
REACTION  IN  NERVOUS  DISEASES* 

THE  REACTION  TO  SIMULTANEOUS  COLD  AND  HOT  STIMULATION 

IN  SYRINGOMYELIA,  TABES  DORSALIS,  MULTIPLE  SCLEROSIS, 

PERIPHERAL  NEURITIS,  AND  A  CASE  PRESENTING  A 

CAPSULO-THALAM IC  SYNDROME 

By  ETHEL  L.  CORNELL,  A. B. 

Departments  of  Neurology  and  Psychology,  Columbia  University 

NEW  YORK  CITY 


OUTLINE 

Introduction — Summary  of  the  normal  reaction  to  the  double  thermal  stimulus 

Consideration  of  individuals'  reaction  in  the  various  phases  of  the  test 

Comparison  of  the  syndromes  studied 

General  tendencies  observable  in  the  reaction  to  double  stimulation — tentative  interpretation 

Conclusions 


The  present  study  is  a  continuation  of  in- 
vestigations of  the  reaction  to  a  double  ther- 
mal stimulus,  preliminary  results  of  which 
were  published  in  the  Neurological  Bulletin 
for  March,  1918.  The  former  paper  dealt  with 
the  reaction  of  normal  subjects.  The  present 
paper  is  a  study  of  twenty-two  patients  suf- 
fering from  organic  nervous  diseases. 

The  general  method  of  the  experiment  was 
to  provide  several  obser\'ations  in  each  of 
which  the  reaction-time  was  measured  for  a 
series  of  stimuli  combining  simultaneous  and 
separate  cold  and  hot  stimulation.  For  de- 
tails of  the  method,  description  of  the  appara- 
tus, plan  of  the  series,  etc.,  the  reader  is 
referred  to  the  previous  article.^    The  patients 

'  The  experiment  as  originally  planned  covered  four 
days,  on  each  of  which  the  double  stimulus  was  given  on 
forty  areas  of  the  body,  and  a  single  stimulus  on  twenty-six 
of  these  areas — the  latter  being  equally  divided  between 
cold  and  hot,  so  that  in  four  experiments,  two  measures  for 
cold  and  hot  respectively  were  obtained  for  each  of  the 
twenty-six  areas,  and  four  measures  of  double  stimulation 
were  obtained  for  forty  areas.    Owing  to  the  difficulty  of 


included  six  cases  of  syringomyelia,  five  of 
tabes  dorsalis,  six  of  multiple  sclerosis,  four  of 
peripheral  neuritis,  and  one  of  a  thalamic 
tumor.  With  the  exception  of  one  case  of 
syringomyelia  obtained  from  Dr.  Tilney's  pri- 
vate practice,  they  were  patients  from  the 
Neurological  Department  of  the  Vanderbilt 
Clinic,  and  the  diagnosis  of  each  case  was 
confirmed  by  the  Chief  of  Clinic,  Dr.  McKen- 
dree.  The  experiments  were  made  during 
1917-1918,  in  the  forenoons,  in  a  room  of  the 
clinic,  free  from  distraction,  the  temperature  of 
which  was  kept  between  22°  and  25°C.  As  a 
rule,  rather  more  preliminary  practice  was 
required  with  these  patients  than  with  normal 

getting  patients  to  return  so  often,  the  plan  was  varied  so 
that  three  observations  should  give  the  same  number  of 
tests.  On  the  first  two  days  forty  double  stimulations  were 
given  as  before,  but  the  twenty-six  areas  were  tested  for 
both  hot  and  cold.  On  the  third  day.  two  series  of  double 
stimulation  were  made,  single  stimuli  being  inserted  only 
often  enough  to  serve  as  a  check.  This  was  not  a  source  of 
suggestion,  however,  because,  as  will  be  seen,  all  patients 
gave  a  considerable  proportion  of  responses  to  double 
stimuh  in  which  only  one  stimulus  was  perceived. 


♦  Submitted  in  partial  fulfillment  of  requirements  for  the  degree  of  Doctor  of  Philosophy 
in  the  Faculty  of  Philosophy,  Columbia  University 

Reprinted  from  the  Neurologic.u,  Bulletin.  Vol.  i.  No.  9,  pp.  335-372- 
Copyright  1918. 

335 


336 


Temperature  Sensitivity 


subjects;  enough  was  given  to  put  the  patient 
thoroughly  at  ease,  and  to  give  the  experi- 
menter an  idea  of  the  general  type  of  response 
to  be  expected  and  a  reasonable  certainty 
that  the  patient  understood  the  directions. 

Analysis  of  the  cases  will  be  made,  on 
the  basis  of  the  tables  and  figures  to  be 
found  at  the  end  of  the  paper,  the  cases  of 
each  syndrome  preceded  b\-  a  summary'  of 
the  findings  for  that  syndrome.  The  various 
syndromes  will  then  be  compared,  the  general 
nature  of  the  disturbance  will  be  discussed, 
and  the  conclusions  that  seem  justified  will 
be  drawn. 

As  a  preliminary',  however,  it  will  be  con- 
venient to  summarize  the  results  of  normal 
reactions  in  a  form  easily  comparable  with 
that  in  which  abnormal  cases  will  be  presented. 

I.  Gross-  Disturbance. — While  normal 
subjects  show  many  individual  differences  in 
the  general  nature  of  their  responses,  nothing 
that  may  be  called  a  gross  disturbance 
appears.  By  this  term  is  meant  a  striking 
disturbance  shown  by  failure  to  react;  or  by 
perverted  response  which  is  a  hot-cold  response 
to  a  cold  stimulus  or  a  cold-hot  response  to 
a  hot  stimulus,  as  well  as  a  hot  response  to 
a  cold  stimulus  or  a  cold  response  to  a  hot 
stimulus. 

II.  Gexer.\l  Char.\cter  of  Reaction. 
Type  of  Response  to  Double  Stimulus. — In 
spite  of  considerable  fluctuation,  normal  sub- 
jects all  show  a  majority  of  C-H  responses, 
and  a  ver\-  small  number  of  single  responses. - 

Range  of  Medians  for  Various  Regions  of 
the  Body. — Among  normals,  no  subject  shows 
a  range  of  more  than  .6  second  for  the  median 
reaction-times  of  all  regions,  in  any  t\'pe  of 
response.  That  is,  a  subject's  reaction-time 
is  fairly  constant  for  all  regions  of  the  body.' 

Extreme  Reactions. — Since  the  measure  used 
is  the  median  and  not  the  average  time,  it  is 
not  much  afTected  by  a  few  extremeh'  long 
reactions.  This  is  desirable,  of  course,  in 
measuring  the  normal  time,  but  in  comparing 
abnormal  cases  with  normal,  it  might  cause 
the  neglect  of  a  number  of  extreme  reactions, 
which  might  be  of  some  importance.     They 

'Neurological  Bulletin  I.  p.  154. 

•  Ibid..  Tables  5-8  and  1 1.  p.  145  el  seq. 


can,  therefore,  be  considered  by  themselves. 
Reactions  of  3.0  seconds  for  separate  stimuli 
or  for  the  first  inter\-al  of  double  responses 
do  not  occur  among  normals.*  Reactions  of 
i.o  second  or  more  as  the  second  interval  of 
double  responses  are  rare,  generally,  though 
they  occur  in  one  subject  in  twenty-five  per 
cent,  of  the  cases.* 

Consistency. — As  it  might  be  possible  for  a 
disturbance  to  be  confined  to  a  few  areas,  but 
at  the  same  time  to  cause  a  large  probable 
error  in  the  measurement  of  the  region  includ- 
ing those  areas,  or  a  large  fluctuation  in  the 
type  of  response  for  that  region,  the  con- 
sistency of  response  was  measured  in  the  case 
of  abnormal  subjects  (Infra,  Table  8).  For 
single  stimuli,  the  measure  used  was  the  per- 
centage of  areas  stimulated  giNnng  two  cor- 
rect responses — this  is  called  consistency  in 
type,  and  varies,  for  different  normal  sub- 
jects, from  85  to  100  per  cent,  for  cold,  and 
from  92  to  100  per  cent,  for  hot.  For  double 
responses,  the  same  measure  was  used — the 
percentage  of  areas  stimulated  gi'ving  two  C-H 
responses,  etc.;  but  this  allowed  more  varia- 
tion, as  each  area  was  stimulated  four  times. 
Consistency  of  C-H  responses  was  high 
among  normals,  ranging  for  different  sub- 
jects from  75  to  100  per  cent. 

The  fluctuation  of  single  areas  in  time  might 
have  been  measured  by  the  de\iation  of  each 
area  from  its  own  a^-erage  if  there  had  been 
a  sufficient  number  of  cases,  but  it  seemed 
best  under  the  circiJmstances  to  take  as  a 
measure  the  range  of  each  area  having  two 
similar  responses.  Thus,  for  normals,  it  was 
found  that  the  percentage  of  areas  which 
responded  at  least  twice  by  C-H  that  had  a 
very  close  range — less  than  .3  second — varied 
from  43  to  73  per  cent,  for  the  first  interval, 
and  from  45  to  80  per  cent,  for  the  second 
interval,  for  different  individuals;  while  the 
percentage  having  a  large  range — i.O  second 
or  more — was  not  more  than  3  per  cent,  for 
the  first  internal,  and  varied  from  o  to  29 
per  cent,  for  the  second.  In  reaction-time, 
separate  stimuli  gave  somewhat  more  con- 
sistent responses — 68  to  96  per  cent,  of  the 
areas  having  a  small   range  for  cold,   50   to 

'Ibid.,  Figs.  I,  2  and  4. 

'  Ihid..  Table  i,  Subj.  H.  p.  141. 


Temperature  Sensitivity 


337 


92  per  cent,  for  hot,  while  the  largest  per- 
centage having  a  range  of  i.O  second  or  more 
was  7.6  per  cent. 

Diminution  of  Intensity  of  Sensation. — 
While  subjects  were  not  asked  to  differentiate 
degrees  of  intensity,  there  were  a  few  instances 
among  normals,  and  many  among  abnormals, 
when  the  sensation  was  reported  as  'warm', 
instead  of  the  usual  'hot'.  Isolated  instances 
of  this  sort  might  be  due  to  sporadic  fluctua- 
tions in  the  temperature  of  the  blocks  used 
for  stimulus;  but  any  considerable  number 
of  such  cases  would  have  to  depend  on  sub- 
jective factors.  Of  course,  if  all  responses 
should  be  'warm',  it  might  be  explained  as 
a  language-habit  of  the  patient;  but  if  any 
distinction  is  made,  it  is  fair  to  assume  that 
it  represents  a  subjective  difference.  Among 
normal  subjects,  no  responses  to  a  separate 
hot  stimulus  were  of  this  sort;  in  the  case  of 
double  stimulation,  the  highest  percentage  of 
warm  responses  was  7  per  cent.  There  was 
no  suggestion  of  any  corresponding  tendency 
to  report  'cool'  instead  of  'cold'. 

Intensification  of  Sensation. — It  would  be 
desirable  to  have  a  measure  of  this  phenome- 
non also,  but  as  any  questioning  by  the  experi- 
menter would  have  been  a  distraction  from 
the  main  purpose  of  the  experiment  and 
would  in  any  case  have  been  too  open  to  sug- 
gestion to  be  very  valuable,  it  is  necessary  to 
resort  to  collateral  evidence.  There  is  much 
less  tendency  to  report  increase  in  intensity, 
verbally,  than  decrease;  partly,  perhaps,  be- 
cause a  very  intense  stimulus  causes  a  reflex 
withdrawal  which  is  itself  an  evidence  of  in- 
crease. This  reflex  is  about  the  only  measure 
we  have  of  intensification,  and  it  is  of  ques- 
tionable value  both  because  of  large  indi- 
vidual differences  and  because  no  record  was 
kept  of  its  appearance  in  normal  subjects. 
It  occurred,  on  abdomen  or  back  in  at  least 
two  subjects,  but  it  was  generally  inhibited 
in  the  course  of  the  preliminary  practice. 

SYRINGOMYELIA 

Six  cases  were  studied.  In  three,  the  dis- 
turbance was  confined  to  one  or  a  few  regions ; 
while  in  the  other  three  there  is  a  general  dis- 
turbance, although  in  two  of  the  latter,  it  is 
more  marked  on  a  few  areas.     The  distur- 


bance is  shown  by  a  marked  lengthening  of 
the  reaction-time  to  single  stimuli;  by 
failure  to  perceive  the  stimulus  at  times;  by 
a  tendency  to  give  perverted  responses;  by 
a  higher  percentage  of  single  responses  than 
normal  to  double  stimuli  and  a  long  reaction- 
time  in  every  type  of  response;  by  a  large 
number  of  extreme  reactions;  by  a  more  than 
normal  inconsistency  of  response;  and  by  a 
tendency  to  report  the  sensation  as  weak  in 
intensity.  Analyses  of  the  cases  follow,  with 
references  to  the  tables  and  figures  at  the 
end  of  the  paper. 

Case  I. — P.  K. ;  age  16;  student;  intelli- 
gence and  cooperation  good. 

Onset. — Spinal  curvature  eleven  years  be- 
fore test. 

Sensation. — Not  described  in  history. 

I.  Gross  Disturbance. — Tables  6  and  7.  No 
failure.  Perversions  occur  on  hand  and  arm  to 
both  cold  and  hot,  but  more  often  to  cold. 

II.  General  Character.  Type  of  Response.— 
Fig.  I.  Cur\'e  is  practically  normal  for  face  and 
legs;  but  on  arms,  abdomen  and  back  single  re- 
sponses to  double  stimuli  are  numerous: — H  on 
arms;  C  on  abdomen  and  back. 

Median  Reaction-tiine. — Table  I.  In  single 
stimuli  C  tends  to  be  somewhat  lengthened,  except 
on  face;  while  H  is  about  normal  except  on  arms  and 
back.  In  double  stimuli  there  is  a  general  tendency 
toward  lengthened  reaction-time  in  the  first  interval 
of  double  responses;  a  marked  similar  tendency  in 
the  second  interval  on  arms  and  back,  and  in  the 
case  of  single  responses. 

Extreme  Reactions. — Table  I,  Fig.  6.  Single  re- 
sponses show  no  more  tendency  to  extreme  reactions 
in  double  than  in  single  stimuli,  and  are  in  both  cases 
confined  to  cold.  The  tendency  is  more  marked  in 
double  responses,  and  is  more  frequent  for  the  second 
interval— slightly  more  frequent  for  H-C  than  for 
C-H  type. 

Consistency. — Table  8.  In  single  stimuli  there  is  a 
marked  inconsistency  in  type  of  response  for  cold 
which  is  most  evident  on  the  right  arm.  The  fluctu- 
ation in  time,  while  greater  than  normal,  is  not  very 
pronounced.  In  double  stimuli  no  type  of  re- 
sponse occurs  twice  on  half  the  areas,  though  C-H 
is  the  most  frequent  type.  The  fluctuation  in  time 
is  greater  than  normal,  and  is  particularly  marked 
for  the  second  interval  of  H-C  responses.  H  er- 
sponses  fluctuate  more  than  C. 


338 


Temperature  Sensitivity 


Diminulion  oj  Sensation. — Table  9.  Hot  is  di- 
minished on  all  regions  in  a  considerable  percentage 
of  cases — more  in  double  than  in  single  stimuli. 
Cold  is  somewhat  diminished  on  arms. 

Intensification. — Table  10.  There  is  no  reflex  e\i- 
dence,  but  patient  reported  that  when  sensation  was 
'sharp'  distinction  was  diflicult.  He  thought  that  it 
was  cold  that  sent  a  shooting  pain  through  region 
and  that  it  'got  worse  and  worse'  while  warm 
'stayed  warm  all  the  time'.  Once  he  said:  "I  guess 
it's  warm,  because  if  it  were  cold  I'd  feel  it."  Per- 
haps this  explains  the  number  of  times  that  C  was 
reported  as  warm.  It  also  implies  an  intensification 
of  cold — though  there  is  evidently  a  hypesthesia. 

Single  stimuli  show  cold  to  be  more  disturbed 
than  hot :  by  its  longer  reaction-time ;  more  extreme 
reactions;  greater  inconsistency  in  type  and  in 
time;  and  greater  likelihood  of  perversion.  But  the 
results  of  double  stimulation  do  not  confirm  this. 
The  C-H  type  has  at  least  a  pluralitN-  of  all  responses; 
reaction  to  hot  tends  to  be  longer  in  double  than  in 
single  stimuli,  while  to  cold  it  remains  about  the 
same;   and  H  responses  are  less  consistent  than  C. 

The  disturbance  is  moderate  in  degree  and  is 
general  rather  than  local,  although  face  and  legs 
escape. 

Case  II. — E.  Wi.  (colored);  age  25;  dental 
student;   intelligence  and  cooperation  good. 

OxsET. — About  eighteen  months  before 
test. 

Sensation. — Described  in  history,  July, 
1917:  "Mild  degree  of  disturbance  to  hot  and 
cold."  Frequently  patient  burned  himself  be- 
cause "sensation  was  so  delayed  he  did  not 
feel  pain  in  time." 

I.  Gross  Disturb.\nce. — Failure  to  react  was 
consistent  on  left  hand.  Perversion  occurred  on 
right  hand  to  hot,  and  on  left  foot  to  cold. 

II.  General  Character.  Type  of  Response. — 
Curve  is  altogether  comparable  with  normal,  except 
for  the  failures  on  left  arm  and  the  per  cent,  of  single 
hot  responses  on  neck. 

Median  Reaction-time. — In  single  stimuli  the  only 
lengthening  is  for  hot,  on  left  arm  and  back.  In 
double  stimuli,  C-H  responses  are  about  normal,  but 
H-C  and  H  responses  show  some  lengthening,  par- 
ticularly on  left  arm  and  abdomen. 

Extreme  Reactions. — The  highest  percentage  of 
extreme  reactions  occurred  for  single  responses  to 
double  stimuli,  thus  indicating  a  real  disturbance 
for  this  type,  both  in  the  failure  to  perceive  the 
double  stimulus  and  in  the  slowing  up  of  the  response 


that  did  occur.  In  double  responses  the  second 
interval  is  extreme  more  often  than  the  first;  but 
H  is  more  frequently  extreme  than  C,  whether  it 
is  the  first  or  second  response. 

Consistency.  In  single  stimuli,  H  is  less  than 
normally  consistent  in  type.  The  fluctuation  in 
time  is  not  excessive — though  greater  than  normal — 
for  either  reaction.  Both  are  very  consistent  (1.  e., 
they  have  a  range  of  less  than  .3  sec.)  in  about  half 
the  areas.  In  double  stimuli,  no  type  occurs  twice 
on  fifty  per  cent,  of  the  areas,  though  C-H  approxi- 
mates this.  The  fluctuation  in  time  is  greater  than 
normal;  and  the  deviation  from  the  normal  is 
greater  in  the  C-H  type  than  in  the  H-C. 

Diminution  of  Sensation.  Hot  is  diminished  on 
all  regions  in  a  considerable  number  of  cases — more 
in  double  than  in  single  stimulation.  The  left  arm, 
however,  which  showed  the  only  gross  disturbance, 
had  relatively  more  reactions  that  were  hot  than  had 
other  regions.  An  initial  perception  of  'warm'  fol- 
lowed by  'hot',  from  .3-2.0  seconds  later,  occurred  a 
number  of  times  but  not  with  any  regularity. 
'Warm'  was  reported  with  temperatures  even  of 
45°  to  50°C.  No  weakening  of  the  cold  sensation 
was  reported. 

Intensification.  No  evidence,  either  reflex  or 
verbal,  was  present. 

Both  single  and  double  stimulations  show  more 
disturbance  of  the  hot  sensation  than  of  the  cold — 
more  inconsistency  in  type;  greater  delay;  more 
extreme  reactions  (at  least  in  double  responses) ; 
greater  tendency  to  inhibition  in  double  stimulation; 
and  more  tendency  to  diminished  intensity. 

Disturbance  is  marked  locally,  affecting,  chiefly 
the  left  hand. 

Case  III. — A.  C;  age  31;  tailor;  intelli- 
gence and  cooperation  fair. 

Onset. — About  nine  years  before  test. 

Sensation. — Described  in  history,  June, 
1917:  "Normal  to  touch  and  apparently,  also 
to  pin-point.  Thermal  sense  absent  down  to 
shoulder  joints." 

I.  Gross  Disturbanxe. — Failures  were  frequent 
or  usual  on  arms  and  neck,  and  occurred  on  ab- 
domen. Sensation  was  entirely  lacking  on  back, 
except  on  shoulder  blades.  Perversion  of  cold  was 
the  rule  on  arms  and  occurred  on  abdomen;  per- 
version of  hot  occurred  on  left  arm  and  abdomen. 

II.  Gener.\l  Character.  Type  of  Response  to 
Double  Slitnuli. — Curve  shows  almost  complete 
absence  of  double  response;  C  type  present  only  on 
face,  neck,  and  abdomen;   all  other  responses  H. 


Temperature  Sensitivity 


339 


Median  Reaction-time. — In  single  stimuli,  reactions 
are  all  very  prolonged — hot  more  so  than  cold.  In 
double  stimuli  the  H  type  only  occurs  with  any  fre- 
quency, and  is  even  slower  than  in  separate  stimuli. 

Extreme  Reactions. — About  half  the  single  re- 
sponses to  double  stimuli  and  single  stimuli  are 
extreme.  Double  responses  are  very  infrequent,  but 
evidently  tend  to  be  relatively  longer  for  the  second 
inter\-al  than  for  the  first. 

Consistency. — As  patient  came  only  twice,  while 
the  e.xperiment  was  planned  for  four  days,  there  were 
not  enough  stimulations  on  each  area  to  provide  a 
measure  for  consistency.  But  consistency  for  single 
stimuli  could  not  be  very  high  for  either  stimulus,  be- 
cause of  the  number  of  failures  and  perversions, 
while  for  double  stimuli,  forty-two  and  five-tenths 
per  cent,  of  the  forty  areas  gave  two  hot  responses, 
and  fifty-three  per  cent,  of  these  had  a  range  of  more 
than  l.o  second. 

Diminution  of  Sensation. — Diminution  of  hot 
occurred  to  a  considerable  extent  on  arms  and 
abdomen,  and  to  some  extent  elsewhere.  'Warm' 
was  reported  with  temperatures  as  high  as  47°C. 
Diminution  of  cold  occurred  on  face. 

Intensification. — On  legs,  the  double  stimulus  and 
the  cold  stimulus  were  several  times  accompanied 
by  a  marked  reflex  withdrawal.  In  one  such  case — 
to  cold — patient  said:  /'Cold  or  hot — something 
strong." 

Both  sensations  are  much  disturbed.  Cold  is 
more  often  perverted  and  is  more  apt  to  cause  a 
reflex  movement;  but  although  hot  is  more  delayed 
and  apparently  more  diminished,  it  takes  most 
marked  precedence  in  double  stimulation. 

The  disturbance  is  marked  generally  over  all  re- 
gions, but  is  profound  on  arms  and  back. 

Case  IV. — L.  A.;  age  49;  paper-hanger; 
intelligence  and  cooperation  fair. 

Onset. — About  ten  months  before  test. 

Sensation. — Described  in  history,  June, 
1917:  "Normal  to  pain  and  touch;  cold  felt 
as  cold,  but  heat  at  times  retarded  and  at 
times  mistaken  for  cold  on  small  finger  and 
up  ulnar  side  of  forearm." 

I.  Gross  Disturb.\nce. — Failure  to  react  oc- 
curred, but  not  persistently,  on  sole  of  each  foot. 
Per\'ersion  of  cold  occurred  on  right  forearm,  right 
thigh,  and  right  side  of  abdomen. 

II.  General  Character.  Type  of  Response. — 
Curve  shows  pfcponderance  of  double  responses 
except  on  arms  and  face,  with  H-C  type  more  fre- 


quent than  normal.  Single  responses  are  frequent 
on  arms  and  face  and  are  present  on  legs;  but  do  not 
occur  on  neck,  abdomen  or  back. 

Median  Reaction-time. — Owing  to  the  fact  that 
patient  came  only  twice,  instead  of  four  times, 
medians  are  not  altogether  reliable.  For  single 
stimuli,  C  seems  to  be  a  little  slower  than  H — espe- 
cially on  face,  left  leg  and  abdomen,  but  times  are 
not  far  from  normal.  For  double  stimuli,  C-H  re- 
sponses are  nearly  normal,  although  face  and  legs 
seem  to  give  rather  long  first  interval  and  face  a  long 
second  interval;  H-C  type  tends  to  have  more 
lengthened  second  intervals  and  generally  longer 
first  intervals;  single  responses  are  long. 

Extreme  Reactions. — The  highest  percentage  of 
extreme  reactions  occurs  for  single  responses  to  dou- 
ble stimuli,  indicating,  in  connection  with  the  long 
medians  for  this  type,  that  these  responses  imply  the 
most  disturbance. 

Consistency. — As  in  Case  3,  consistency  cannot  be 
measured.  It  would  be  higher,  with  single  stimuli, 
for  H  than  for  C,  since  the  former  had  no  errors. 
Results  of  double  stimulation  cannot  be  predicted; 
twelve  and  five-tenths  per  cent,  of  the  areas  gave 
two  responses  C-H,  and  an  equal  number  gave  two 
H-C. 

Diminution  of  Sensation. — Hot  stimulus  was 
always  reported  'warm'.  Once,  patient  said:  "\Varm 
— good  warm."  As  his  English  was  somewhat  lim- 
ited, this  may  have  been  merely  a  language  habit. 
No  analogous  cool  was  reported. 

Intensification. — No  evidence. 

Contrary  to  the  findings  reported  in  the  history, 
cold  sensation  seems  to  be  more  interfered  with 
than  hot,  in  both  kinds  of  stimulation — it  is  slower 
separately  and  has  more  tendency  to  extreme  reac- 
tion— in  double  responses  as  well  as  in  single  stimuli; 
only  cold  is  perverted;  and  in  double  responses,  hot 
takes  precedence. 

The  disturbance  is  moderate  and  is  general  rather 
than  local. 

Case  V. — J.  CI.;  age  21;  accountant;  in- 
telligence and  cooperation  good. 

Onset. — About  four  years  before  test. 

Sensation. — Described  in  history,  July, 
1915:  "Touch,  deep  sensibility,  and  position 
sense  O.  K.  Touch  uncertain  {sic!) ;  heat  and 
cold  not  differentiated  over  arms  and  upper 
chest." 

I.  Gross  Disturbance. — Failure  to  react.  Com- 
plete absence  of  sensation  on  upper  extremities,  for 
hot  stimulus  up  to  52°;  and  for  cold  to  16°.    Ice  felt 


340 


Temperature  Scnsiti\'ity 


cold  when  grasped  in  hand,  and  cool  on  right  forearm 
after  several  seconds.  Perversion  of  cold  was  fre- 
quent, but  in  a  number  of  cases  a  dubious  correction 
was  made.  Indeed,  patient  was  generally  unable  to 
tell,  when  he  reported  first  one  and  then  the  other 
(whether  the  stimulus  was  double  or  single),  whether 
both  stimuli  were  present  or  whether  he  had  first 
made  a  mistake — the  second  sensation  seemed  to 
take  the  place  of  the  first. 

II.  General  Character.  Type  of  Response. — 
Curve  shows  marked  predominance  of  H  type,  but 
greater  frequency  of  C-H  than  of  H-Cr  C  responses 
are  infrequent  except  on  face. 

Median  Reaction-time. — Reaction-time  is  prac- 
tically normal.  In  single  stimuli  C  seems  to  be  a 
trifle  slower  than  H,  and  a  little  delayed  on  abdomen. 
In  double  stimuli,  second  interval  is  slightly  long  in 
double  responses;  single  responses  are  prompt  except 
in  the  case  of  C  responses  on  back. 

Extreme  Reactions. — The  only  tendency  to  extreme 
reactions  is  in  the  case  of  the  second  interval  of 
double  responses,  where  half  the  reactions  are  over 
l.o  second. 

Consistency. — Except  for  the  marked  inconsistency 
in  type  of  separate  cold  stimuli  (due  to  the  frequent 
perversions)  and  a  larger  than  normal  fluctuation  for 
this  type,  patient's  responses  are  very  consistent  in 
both  type  and  time;  but  in  double  stimuli,  it  is  the 
H  type,  not  C-H,  that  is  consistent. 

Diminution  of  Sensation. — No  diminution  of  sen- 
sation occurred  in  the  first  report;  but  twice  on  the 
cheeks,  the  double  stimulus,  although  reported 
'hot',  evoked  the  comment:  "It  didn't  feel  either 
way  afterward" — "it  was  just  lukewarm  afterward." 
A  response  of  'hot'  was  also  occasionally  followed  by 
"a  little  cold  at  beginning." 

Intensification. — There  was  no  evidence  of  this. 

Except  for  the  anesthetic  regions,  hot  seems  to  be 
intact;  while  cold  shows  some  disturbance — its  per- 
version; its  slightly  longer  time;  its  inhibition  in 
double  stimuli;  the  fact  that  when  the  double  stimu- 
lus was  perceived,  hot  was  more  likely  to  follow 
when  cold  was  felt  first;  and  the  few  cases  when  cold 
was  perceived  without  hot;   are  evidence  of  this. 

The  disturbance  is  complete  locally,  and  is  slight 
generally. 

Case  VI. — B.  T.  (female);  age  22;  stitcher; 
intelligence  and  cooperation  fair. 

Onset. — About  eight  years  before  test. 

Sensation. — Described  in  history,  Octo- 
ber, 1 91 7:  "Over  areas  corresponding  to  sixth 
to  eighth  cervical  segments  of  cord,  on  right 
side,  there  is  diminished  pain  and  temperature 


sensation,   but   touch   is   but   slightly   dimin- 
ished." 

I.  Gross  Disturbance. — Failure  to  react  was 
the  rule  on  left  arm  and  was  frequent  on  right  arm. 
Perversion  of  cold  was  uniform  on  right  arm. 

II.  General  Character.  Type  of  Response. — 
Curve  is  normal  except  on  arms  and  face. 

Median  Reaction-time. — Number  of  cases  is  few, 
because  patient  came  only  once.  Times  seem  to  be 
somewhat  longer  than  normal  in  all  cases  except  the 
second  interval  of  double  responses.  This  may  be 
due  to  insufficient  adaptation  to  the  task  or  is,  per- 
haps, an  individual  characteristic.  The  longest 
times  are  for  H  responses  to  double  stimuli. 

Extreme  Reactions. — Occur  with  frequency  only 
in  single  responses  to  double  stimuli. 

Consistency. — Cannot  be  measured  from  one  ob- 
servation. 

Diminution  of  Sensation. — All  hot  stimuli  (tem- 
peratures 40-44)  were  called  warm. 

Intensification. — There  was  no  evidence. 

The  perversion  of  cold  and  the  fact  that  single 
responses  to  double  stimuli  were  more  often  'hot' 
than  'cold',  suggest  that  cold  is  somewhat  more  dis- 
turbed than  hot. 

The  disturbance  is  local  and  quite  marked. 

TABES  DORSALIS 

The  five  cases  studied  show  some  distur- 
bance of  a  general  character — marked  in  two; 
slight  in  two;  and  moderate  in  one.  The 
disturbance  is  shown  by  some  tendency 
toward  perversion;  by  a  marked  deviation 
from  the  normal  type  of  response;  by  a  ten- 
dency toward  somewhat  lengthened  reaction- 
times — especially  with  the  double  stimulus; 
by  the  number  of  extreme  reactions;  the  in- 
consistency of  response;  and  by  a  tendency 
toward  intensification  of  the  sensation.  Anal- 
yses of  the  cases  follow: 

Case  VII. — G.  C;  age  39;  barber;  intel- 
ligence rather  inferior. 

Onset. — About  two  years  before  test. 

Sensation. — Described  in  history,  June, 
191 7:  "Hypesthetic  to  pin-prick  and  to 
cotton  wool." 

I.  Gross  Disturbance. — No  failure  to  react. 
Perversion  of  cold  occurred  consistently  on  lateral 
surface  of  both  legs. 


Temperature  Sensitivity 


341 


II.  General  Character.  Type  of  Response. — 
Curve  shows  more  single  reactions  than  normal  on 
every  region  except,  perhaps,  the  face;  being  par- 
ticularly high  on  legs,  abdomen  and  back.  H-C  re- 
sponses are  slightly  more  frequent  than  C-H.  There 
is  a  considerable  number  of  doubtful  responses. 

Median  Reaction-time. — In  single  stimuli  all 
regions  give  lengthened  times  except  neck,  abdomen 
and  back  for  H;  and  C  is  somewhat  slower  than  H. 
In  double  stimuli,  C-H  responses  show  much 
lengthened  first  interval  and  long  second  interval 
on  left  leg  and  back.  H-C  responses  are  long  in  both 
intervals.  Single  responses  are  also  long,  H  some- 
what less  than  C. 

Extreme  Reactions. — Extreme  reactions  are  fre- 
quent— more  so  in  double  than  in  single  stimuli,  and 
more  for  the  first  interval  and  for  single  responses 
than  for  the  second  interval.  The  tendency  for  both 
interv'als  is  more  evident  in  H-C  than  in  C-H  type. 

Consistency. — Reaction  to  all  kinds  of  stimulus  is 
ver>'  inconsistent  in  type  and  fluctuating  in  time, 
except  for  the  first  interval  of  C-H  responses. 

Diminution  of  Sensation. — Diminution  of  hot 
occurred  to  some  extent  in  both  single  and  double 
stimuli;  cold  was  diminished  to  a  much  greater 
degree  than  in  other  subjects,  chiefly  in  double 
stimuli. 

Intensification. — Some  refle.xes  were  present  but 
were  not  ver>'  marked.  They  accompanied  cold 
stimulation  and  double  stimulation,  and  were  mostly 
on  abdomen  and  back. 

Cold  is  evidently  somewhat  more  disturbed  than 
hot — it  is  more  lengthened;  shows  some  perversion; 
occurs  somewhat  less  frequently  than  H  as  the  first 
response;  and  is  considerably  diminished  in  inten- 
sity. 

The  disturbance  is  quite  marked  and  is  general 
rather  than  local. 

Case  VIII. — P.O.;  age  36;  railroadman; 
intelligence  and  cooperation  good. 

Onset. — About  three  years  before  test. 

Sensation. — Described  in  history,  May, 
191 7:  "Touch  and  pain  showed  hypesthetic 
region  on  back,  with  bordering  hyperesthetic 
area.  Vibratory  sensation  diminished  on 
lower  extremities."  (Temperature  not  men- 
tioned.) 

I.  Gross  Disturb.\nce. — No  failure  to  react. 
Per\^ersion  of  hot  on  soles  of  feet;  of  cold  on  back. 

II.  General  Ch.^racter.  Type  of  Response. — 
All  are  rather  frequent.  On  the  legs,  C-H  and  C 
predominate;  on  neck  and  back,  H. 


Median  Reaction-time. — In  single  stimuli  medians 
are  about  normal,  but  H  is  somewhat  quicker  than 
C.  In  double  stimuli  the  reaction  is  slower  and  more 
variable;  first  inter\'al  of  C-H  and  second  interval  of 
H-C  are  about  normal.  H  responses  are  generally 
slower  than  C. 

Extreme  Reactions. — In  -single  stimuli  extreme 
reactions  are  rare  and  occur  only  for  C.  Double 
stimuli  increase  the  number  of  extreme  reactions, 
particularly  for  single  responses  and  for  second  in- 
terval of  double.  Hot,  either  as  first  or  second  re- 
sponse, is  more  apt  to  be  extreme. 

Consistency. — In  single  stimuli,  consistency  in  type 
is  normal  for  both,  but  fluctuation  in  time  is  marked 
for  C.  In  double  stimuli,  no  type  gives  even  a  mod- 
erate degree  of  consistency;  in  time,  the  fluctuation 
is  greater  than  for  single  stimuli  and  is  noticeably 
greater  with  C-H  than  w-ith  H-C  responses. 

Diminution  of  Sensation. — There  is  no  evidence  of 
this. 

Intensification. — Reflex  retractions,  sometimes  so 
pronounced  as  to  interfere  with  stimulation,  occurred 
on  legs,  abdomen  and  back,  chiefly  accompanying 
double  stimulus.  They  were  most  violent  on  back, 
and  increased  rather  than  diminished  as  experiment 
progressed.  Patient  declared  the  stimulus  felt 
'scalding'  and  'icy'.  With  separate  stimuli  often, 
and  not  infrequently  with  double,  patient  reported  a 
second  hotter  or  colder  sensation  from  one  to  four 
seconds  after  first. 

Although  in  single  stimuli  C  is  somewhat  slower 
and  more  apt  to  be  extreme  than  H — as  well  as  more 
fluctuating — in  double  stimuli,  the  opposite  is  the 
case:  hot  is  delayed  more,  whether  as  first  or  second 
response  or  whether  it  occurs  alone,  and  is  more  apt 
to  be  extreme,  although  it  is  still  less  fluctuating 
than  cold. 

The  disturbance  is  moderate  and  general,  though 
less  marked  on  upper  extremities. 

Case  IX. — J.  Co.;  age  37;  tailor;  intelli- 
gence good,  cooperation  fair. 

Onset. — About  seven  years  before  test. 

Sensation. — Described  in  history,  October, 
1 91 7:  "Hj'pesthesia  partial  to  pain  and 
vibratory  sensation." 

I.  Gross  Disturbance. — Failure  to  react  oc- 
curred, chiefly  with  hot  stimulus  on  sole  of  left  foot. 
Perv-ersions  of  both  stimuli  occurred — of  hot  on 
face;  more  often  of  cold,  on  foot  and  back. 

II.  General  Character.  Type  of  Response. — 
Curse  shows  C-H  responses  in  general  to  be  most 
frequent;    H-C  very  infrequent;    C  almost  absent 


342 


Temperature  Sensitivity 


except  on  legs  where  they  predominate;  H  very 
frequent  on  right  arm,  abdomen  and  back. 

Median  Reaction-lime. — The  only  tendenc\-  toward 
lengthening  of  reaction-time  occurs  for  the  second 
interval  of  H-C  responses. 

Extreme  Reactions. — The  number  of  e.xtreme  reac- 
tions is  small.  It  is  greater  for  single  stimuli  than 
for  double,  except  in  the  second  inter\al,  and  occurs 
only  with  hot  stimuli. 

Consistency. — In  single  stimuli,  consistency  in  both 
t>'pe  and  time  is  quite  normal.  In  double  responses, 
while  no  t>pe  has  a  verj-  high  consistency,  the  C-H 
type  attains  it  in  forty-live  per  cent,  of  the  areas. 
The  fluctuation  in  time  is  not  great. 

Diminution  of  Sensation. — There  is  a  considerable 
tendency  to  report  'warm'  instead  of  'hot' — slightly 
greater  in  the  case  of  double  than  of  single  stimuli. 
Twice,  an  initial  perception  of  warm  was  followed 
by  hot,  not  more  than  1.5  seconds  later.  No  diminu- 
tion of  cold  was  reported. 

Intensification. — Stimulation  on  back  was  some- 
times accompanied  by  a  reflex,  but  the  tendency  was 
not  marked,  and  there  was  no  verbal  comment. 

The  type  of  response  suggests  that  on  the  legs  the 
hot  sensation  is  more  interfered  with  than  the  cold; 
elsewhere  there  is  not  apparent  a  greater  disturbance 
of  one  than  the  other,  except  in  the  rather  general 
tendency  toward  a  diminution  of  the  intensity  of  hot. 

The  disturbance  is  verj'  slight,  but  general. 

Case  X. — L.  F.  (female);  age  53;  cook; 
intelligence  rather  inferior;  cooperation  poor, 
influenced  by  suggestion.* 

Onset. — About  two  years  before  test. 

Sensation. — Described  in  histor%^  Sep- 
tember, 191 7:    "Normal." 

I.  Gross  Disturb.vnce. — Xo  failure  to  react. 
Per\-ersion  of  cold  was  general — the  response  usually 
H-C.  This  was  evidently  due,  at  least  in  part,  to 
suggestibility  and  inference,  as  H-C  responses  were 
frequent  to  hot  stimulus  also.  When  error  was 
pointed  out  to  her  on  third  day,  the  number  of  wrong 
responses  was  reduced  to  four,  all  of  which  occurred 
on  arms  and  legs. 

II.  Gener.\l  Char.\cter.  Type  of  Response. — 
Curve  shows  H-C  t>pe  to  be  decidedly  predominant, 

'  Patient  was  unduly  impressed  by  instruction  to  react 
as  quickly  as  possible,  and  evidently  inferred  that  nearly 
all  stimuli  were  double.  She  seemed  to  think  the  test  a 
'treatment'  and  to  consider  the  stimulus  more  important 
than  the  response.  On  the  third  day  her  error  in  giving 
double  responses  to  single  stimuli  was  pointed  out.  and 
the  error  was  reduced,  though  not  eliminated,  by  her  in- 
creased attention. 


but  its  significance  is  questionable,  as  single  stimuli 
also  gave  this  response  most  frequently.  Single  C 
responses  occur  only  on  arms  and  legs;  H  only  on 
abdomen  and  back. 

Median  Reaction-time. — In  single  stimuli,  while 
there  is  much  variability  owing  to  the  small  number 
of  correct  responses,  no  significant  tendency  to  long 
reaction-time  is  apparent.  In  double  stimuli,  the 
only  lengthening  occurs  for  the  second  inter\'al  of 
both  C-H  and  H-C  responses  on  the  face,  and  in 
general  for  C  responses. 

Extreme  Reactions. — There  is  no  ver>'  marked  ten- 
dency to  extreme  reaction.  It  is  perhaps  most  signifi- 
cant in  single  responses  to  double  stimuli;  but  while 
in  single  stimuli  all  extreme  reactions  are  to  hot,  in 
single  responses  to  double  stimuli  they  are  all  to  cold. 

Consistency. — In  spite  of  three  trials  instead  of  two 
for  each  area,  single  stimuli  gave  a  low  degree  of  con- 
sistency in  type  and  a  larger  than  normal  fluctuation 
in  time.  Double  stimuli — with  three  instead  of  four 
trials — were  quite  consistent  in  the  H-C  type.  Fluc- 
tuation in  time  was  not  marked  and  was  normal  for 
second  inter\-al  of  both  t>pes. 

Diminution  of  Sensation. — There  is  no  evidence  of 
this. 

Intensification. — Reflexes  are  ver>-  numerous  and 
occur  on  left  arm  and  face  as  well  as  legs,  abdomen 
and  back.  They  occur  more  with  single  than  with 
double  stimulation  and  more  with  cold  than  hot. 
On  abdomen,  patient,  asked  which  was  more  intense, 
called  the  cold  (of  19°)  'worse'  than  the  hot  (44°). 

One  can  hardly  say  that  either  sensation  is  more 
disturbed.  At  least  a  tendency  for  hot  to  take  pre- 
cedence, in  spite  of  apparently  greater  intensification 
for  cold,  seems  to  be  present. 

There  is  evidenth-  a  slight  general  disturbance  the 
real  nature  of  which  is,  however,  masked  by  patient's 
desire  to  'do  well'. 

Case  XI. — H.  D.;  age  49;  metal  lather; 
intelligence  and  cooperation  good. 

Onset. — .^bout  three  years  before  test. 

Sens.\tion. — Described  in  historj',  June, 
191 7:    O.  K.  (except  blurring  vision). 

I.  Gross  DiSTt.TRB.\N'CE. — Neither  failure  nor  |>er- 
version  occurred. 

II.  Gener.\l  Character.  Type  of  Response. — 
Curse  shows  a  marked  predominance  of  C,  with  in- 
frequent double  responses. 

Median  Reaction-time. — Reaction  is  gencralK- 
quite  slow.  In  single  stimuli  C  is  slower  than  H; 
but  in  double  stimuli  H-C  and  H  are  slower  than 
C  and  C-H. 


Temperature  Sensitivity 


343 


Extreme  Reactions. — The  tendency  to  extreme 
reactions  is  very  marked  in  double  stimuli,  rather 
more  when  both  stimuli  are  perceived.  In  all  types 
the  tendency  is  greater  for  hot  than  for  cold,  but  this 
is  not  evident  in  single  stimuli. 

Consistency. — Single  stimuli  give  perfectly  con- 
sistent responses  in  type,  and  the  fluctuation,  though 
greater  than  normal,  is  not  extreme.  In  double 
stimuli,  C  type  is  quite  consistent;  fluctuation  is 
high,  especially  for  double  responses. 

Diminution  of  Sensation. — There  was  some  general 
diminution  of  hot,  more  in  single  than  in  double 
stimuli,  and  of  cold  on  the  left  hand. 

Intensification. — The  abdomen  and  back  gave,  not 
infrequently,  slight  reflexes;  but  they  were  evidently 
to  considerable  extent  inhibited.  The  sensation  was 
extremely  disagreeable,  according  to  patient's  state- 
ment, especially  cold. 

Although  in  single  stimuli  cold  is  somewhat  slower 
than  hot;  in  double  stimuli  the  hot  sensation  is 
evidently  more  disturbed,  as  is  shown  by  the  greater 
frequency  of  the  cold  response,  and  the  greater  delay 
and  greater  tendency  to  extreme  reactions  in  hot 
responses,  whether  in  double  responses  or  alone. 

The  disturbance  is  marked  and  general. 

MULTIPLE  SCLEROSIS 

The  six  cases  studied  show  sHght  distur- 
bances which  are  general  in  four,  and  local  in 
two.  Disturbance  is  shown  chiefly  by  devia- 
tion from  the  normal  type  of  response  to 
double  stimuli;  by  lengthened  second  inter- 
vals of  double  responses;  and  by  some  ten- 
dency toward  diminution  of  sensation.  Analy- 
ses of  the  cases  follow: 

Case  XII. — E.  Wa.  (female);  age  43; 
housewife;  intelligence  good,  cooperation  ex- 
cellent. 

Onset. — About  eighteen  months  before 
test  (remission  for  months  until  a  year 
previous). 

Sensation. — Described  in  history,  January, 
1918:   "Intact — pain,  touch,  temperature." 

I.  Gross  Disturbance. — No  failure  to  react. 
Perversion  not  present. 

II.  Gener.\l  Character.  Type  of  Response. — 
The  curve  shows  a  tendency  to  predominance  of 
H-C  and  H  responses,  particularly  on  upper  part  of 
body;  the  tendency  is  much  less  clear  on  legs,  ab- 
domen and  back,  and  is  rather  strikingly  reversed  on 
the  left  leg. 


Median  Reaction-time. — In  single  stimuli  medians 
are  normal  with  slight  variability,  e.xcept,  perhaps, 
on  the  neck  and  left  leg  for  C,  and  abdomen  for  H, 
where  there  is  some  retardation.  In  double  stimuli, 
double  responses  show  a  slight  lengthening  of  first 
interval  and  a  strikingly  long  second  interval,  the 
more  remarkable,  considering  the  promptness  of 
reaction  separately.  C  and  H  responses  are  delayed 
on  legs  and  abdomen — H  more  than  C. 

Extreme  Reactions. — The  tendency  toward  extreme 
reactions  in  single  stimuli,  and  in  the  first  interval  of 
double  responses,  is  negligible;  while  for  the  second 
interval  ninety  per  cent,  of  responses  are  i.o  second 
or  more.  Single  responses  to  double  stimuli  show 
the  tendency  to  a  small  degree. 

Consistency. — In  single  stimuli  there  is  no  incon- 
sistency in  type.  The  fluctuation  in  time,  however, 
is  rather  more  than  normal.  In  double  stimuli  no 
type  has  a  very  great  consistency — H  being  the  most 
consistent.  In  time,  double  responses  have  not  more 
than  normal  fluctuation  in  the  first  interval,  but 
fluctuate  markedly  in  the  second. 

Diminution  of  Sensation. — There  is  some  diminu- 
tion of  hot,  considerably  more  frequent  in  single  than 
in  double  stimulation.  In  a  considerable  number  of 
these  cases,  however,  the  initial  perception  of  warm 
was  followed  by  hot,  from  .8  to  4.6  seconds  later. 
In  several  of  these  cases  the  interval  was  over  2.0 
seconds,  which  is  in  itself  quite  unusual.  No 
diminution  of  cold  was  reported. 

Intensification. — There  were  no  reflex  retractions, 
although  in  this  case,  as  in  most  multiple  sclerosis 
cases,  jerks  of  the  legs  were  frequent — a  random  jerk, 
rather  than  an  attempt  to  withdraw  from  the 
stimulus.  Patient  often  reported,  however,  that 
sensation  was  a  'shock',  which  made  the  distinction 
difficult;  but  she  asserted  positively  that  it  had  no 
sting  like  very  hot  or  very  cold  sensations. 

Although  hot  tends  to  take  precedence,  except  on 
legs  and  abdomen,  it  also  shows  a  tendency  to 
diminution  and  to  an  exaggeration  of  what  may  be 
called  the  crescendo  eff'ect  (perception  of  warm  fol- 
lowed by  hot).  It  can  hardly  be  said  that  one  sensa- 
tion is  more  disturbed  than  the  other.  What  is 
chiefly  disturbed  is  the  immediate  perception  of  the 
doubleness,  regardless  of  which  is  perceived  first. 

The  disturbance  is  slight  and  general,  although  it 
is  more  marked  on  legs  and  abdomen. 

Case  XIII. — ^J.  Q.;  age  25;  occupation 
not  stated;   intelligence  and  cooperation  fair. 

Onset. — About  three  years  before  test. 

Sensation. — Described  in  history,  June, 
1916:    O.  K.    Dorsal    roots   were   cut,  July, 


344 


Temperature  Sensitivity 


1916.  Sensory  examination,  October,  1916, 
showed  analgesia;  temperature  anesthesia  on 
ventral  surface  of  leg — left  more  than  right; 
and  hyperesthesia  to  cold  on  dorsal  aspect  of 
thighs  and  lateral  part  of  legs. 

I.  Gross  Disturbance. — Failure  to  react  oc- 
curred once  but  was  insignificant.  Perversion  was 
not  present. 

II.  General  Character.  Type  of  Response. — 
The  curve  is  quite  fluctuating  for  different  regions. 
It  is  to  be  noted  that  H-C  responses  do  not  occur; 
that  the  abdomen  has  a  normal  percentage  of  C-H 
responses;  and  that,  except  on  face  and  neck,  C  is 
more  frequent  than  H. 

Median  Reaction-time. — In  single  stimuli  medians 
are  prompt,  with  small  variability — C  slightly 
quicker  than  H.  In  double  stimuli,  C  responses  are 
normal  whether  alone,  or  as  first  interval;  while  hot 
is  delayed  both  in  H  and  in  C-H  responses. 

Extreme  Reactions. — The  only  tendency  to  extreme 
reactions  was  in  second  interval  of  double  responses. 
Most  marked  on  legs  and  back;  least  on  abdomen. 

Consistency. — Single  stimuli  give  very  consistent 
responses  both  in  type  and  time.  In  double  stimuli, 
C-H  and  C  responses  each  occur  twice  on  nearly 
half  the  areas.  In  time,  the  only  fluctuation  of 
extent  is  in  the  second  interval  of  C-H  responses. 

Diminution  of  Sensation. — Hot  stimulus  was  regu- 
larly reported  'warm' — even  with  temperatures  up 
to  47°.  As  patient  was  English-speaking,  and  as 
response  'hot'  did  occur,  this  is  probably  not  a  mere 
language  habit.    No  diminution  of  cold  was  reported. 

Intensification. — Refle.xes  occurred  with  cold  stim- 
uli and  with  double  stimuli  to  which  response  was 
'cold'  on  back.  (Temperature  of  47°  evoked  no 
reflex.)  Jerks  of  legs,  but  not  withdrawals,  also 
occurred. 

While  both  sensations  appear  to  be  normal  in 
single  stimulation,  double  stimuli  show  some  inter- 
ference with  the  hot  in  the  long  second  interval,  and 
in  the  small  number  of  cases  in  which  hot  occurs 
alone,  as  well  as  in  the  delay  of  such  responses. 

The  disturbance  is  slight  but  general. 

Case  XIV. — G.  P. ;  age  38;  tailor;  intelli- 
gence and  cooperation  fair. 

Onset. — Four  years  before  test. 

Sensation. — Described  in  history,  April, 
1918:    Normal. 

I.  Gross  Disturbance. — No  failure  to  react. 
One  instance  of  perversion  of  hot  occurred. 


II.  General  Character.  Type  of  Response. — 
Curve  is  practically  normal — e.xcept  on  legs,  where 
percentage  of  double  responses  falls  and  that  of  C 
rises.    C  is  much  more  frequent  than  H. 

Median  Reaction-lime. — In  single  stimuli  medians 
are  normal,  with  a  normal  amount  of  overlapping 
of  C  and  H.  In  double  stimuli,  H-C  typo  shows 
some  lengthening  of  first  interval,  and  of  second 
interval  on  legs.  Lengthening  of  second  interval  on 
legs  is  also  present  in  C-H  responses,  which  are  other- 
wise normal.    Single  responses  show  some  delay. 

Extreme  Reactions. — Extreme  reactions  are  not 
very  frequent  and  occur  chiefly  in  second  interval  of 
double  responses — more  in  H-C  than  in  C-H. 

Consistency. — In  single  stimuli  consistency  is  nor- 
mal, for  both  type  and  time.  In  double  responses, 
the  only  abnormality  in  type  is  in  the  number  of 
areas  giving  consistent  C  responses.  In  time  the 
fluctuation  is  generally  greater  than  normal,  and  is 
marked  in  the  second  inter\'al  of  H-C  responses. 

Diminutiofi  of  Sensation. — 'Warm'  was  more  fre- 
quent than  'hot';  and  somewhat  more  frequent  with 
double  than  with  single  stimuli.  Occasionally,  that 
is  in  three  instances,  the  perception  of  warm  was 
followed  by  hot — i.i,  1.5,  and  2.0  seconds  later. 
The  only  instance  of  diminution  of  cold  occurred  on 
the  hand,  where  the  response  'cold'  followed  2.0 
seconds  after  'cool'. 

Intensification. — There  were  frequent  jerks  of  legs, 
but  not  a  real  withdrawal.  On  abdomen,  however, 
patient  sucked  in  his  breath  at  the  cold  stimulus, 
and  expressed  surprise  at  its  intensity. 

The  interference,  in  this  case,  is  chiefly  in  the  im- 
mediate perception  of  doubleness — whichever  re- 
sponse came  first — although  when  either  was  in- 
hibited, it  was  more  likely  to  be  hot. 

The  disturbance  is  very  slight,  affecting  chiefly  the 
legs. 

Case  XV. — J.  T.;  age  19;  student;  in- 
telligence and  cooperation  good. 

Onset. — About  eleven  months  before  test. 

Sensation. — Described  in  history,  Novem- 
ber, 1917:  O.  K. 

I.  Gross  Disturb.ance. — No  failure  to  react. 
Perversion  not  present. 

II.  General  Character.  Type  of  Response. — 
Curve  shows  H  type  to  be  most  frequent,  except  on 
face,  where  C-H  prevails;  C  type  is  very  infrequent 
except  on  face. 

Median  Reaction-time. — In  single  stimuli  times  are 
normal;  but  are  longer  on  legs  than  elsewhere.  H 
seems  to  be  a  little  quicker  than  C.     In  double 


Temperature  Sensitivity 


345 


stimuli,  C-H  responses  siiow  a  delay  only  in  the 
second  interval  on  right  leg;  H-C  responses  are  pro- 
longed in  both  intervals  on  face,  legs,  and  abdomen 
— and  in  second  interval  on  right  arm.  Single  re- 
sponses are  slow  on  legs. 

Extreme  Reactions. — There  is  some  tendency 
toward  extreme  reactions,  which  is  considerable  only 
in  the  case  of  the  second  interval  of  double  responses, 
especially  of  the  H-C  type. 

Consistency. — In  single  stimuli  there  is  no  incon- 
sistency in  type,  but  rather  more  than  normal  fluc- 
tuation in  time — especially  for  C.  In  double  stimuli 
H  type  has  a  high  degree  of  consistency,  and  C-H 
responses  are  fairly  consistent.  The  fluctuation  in 
time  is  not  considerable  e.xcept  for  H-C  type,  al- 
though C  type  shows  much  greater  fluctuation 
than  H. 

Diminution  of  Sensation. — There  is  a  slight  degree 
of  diminution  of  both  sensations,  more  in  the  case  of 
double  than  of  single  stimuli — chiefly  on  legs  and 
face  for  hot,  and  on  legs  and  arms  for  cold. 

Intensification. — The  only  suggestion  of  this  was 
two  reflex  withdrawals  on  back;  and  one  verbal  re- 
port of  'very  hot'. 

Single  stimuli  show  scarcely  any  abnormality,  but 
suggest  a  slight  retardation  of  cold  and  a  slightly 
greater  variability.  Double  stimuli  confirm  the 
view  that  cold  is  more  interfered  with — it  is  likely 
to  be  absent;  if  present,  it  is  much  more  likely  to  be 
followed  by  hot  than  to  follow  it;  and  it  shows  more 
fluctuation  and  more  extreme  reactions  than  hot 
either  as  the  second  interval  or  as  a  single  response. 
It  is  interesting  to  note,  in  this  connection,  the  num- 
ber of  uncertain  responses,  as  when  patient  started  to 
enunciate  'cold'  but  changed  his  mind;  or  said  'cold' 
and  then  thought  it  was  a  mistake.  As  in  case  of 
J.  CI.,  hot,  when  perceived,  very  often  seems  to  dis- 
place cold. 

The  disturbance  is  moderate  and  general. 

Case  XVI. — I.  R.  (female) ;  age  29;  knitter; 
intelligence  and  cooperation  good. 

Onset. — About  six  years  before  test. 

Sensation. — Dorsal  roots  were  cut  Janu- 
ary, 1915 — L  II,  III,  V,  S  I.  Examination  in 
June,  1915,  showed  loss  of  sensations  of 
touch,  heat  and  cold  over  area  L  I  and  L  II 
segments. 

I.  Gross  Disturbance. — No  failure  to  react. 
Perversions  not  present. 

II.  Gener.\l  Character.  Type  of  Response. — 
Curve  shows  much  apparent  fluctuation  between 


C-H  and  H-C  type  (number  of  cases  was  small  as 
patient  came  only  once)  but  is  evidently  normal, 
except  for  a  larger  projiortion  of  single  responses  than 
normal  on  legs  and  back. 

Median  Reaction-time. — Single  stimuli  give  per- 
fectly normal  times  except  on  left  leg,  where  both  C 
and  H  show  some  delay.  Double  stimuli  appear 
slightly  to  increase  the  time  of  the  first  interval,  and 
very  slightly  the  second  interval — and  more  for  C-H 
than  for  H-C  responses,  except  on  right  arm. 

Extreme  Reactions. — Practically  the  only  extreme 
reactions  occurred  in  the  second  interval  of  double 
responses,  more  often  in  H-C  than  in  C-H  responses. 

Consistency. — No  measure,  as  there  was  only  one 
observation. 

Diminution  of  Sensation. — While  there  were  no 
reports  of  'warm',  and  only  occasionally  one  of  'cool', 
patient  said  that  sensation  on  legs  'felt  funny  .  .  . 
only  a  little  .     .     .  different  from  rest  of  body'. 

Intensification. — Reflexes  were  frequent  on  legs 
and  abdomen,  but  the  sensation  was  not  described 
as  intense. 

What  slight  disturbance  there  is  seems  to  be  about 
equal  for  both  sensations. 

There  is  a  very  slight  disturbance,  affecting  chiefly 
the  legs. 

Case  XVII. — J.  B.;  age  42;  peddler;  in- 
telligence and  cooperation  good,  but  patient 
had  only  slight  knowledge  of  English. 

Onset. — About  seven  months  before  test. 

Sensation. — Not  noted  in  history,  April, 
1918. 

I.  Gross  Disturbance. — No  failure  to  react  nor 
perversion. 

II.  General  Character.  Type  of  Response. — 
Reaction  is  quite  uniformly  C-H,  except  for  single 
C  responses  on  legs  and  back. 

Median  Reaction-time. — In  single  stimuli  medians 
are  normal ;  H  is  consistently  slightly  slower  than  C. 
In  double  stimuli  the  only  tendency  to  delay  is  in  the 
second  interval,  which  is  greater  than  i.o  second  for 
all  regions  except  abdomen  and  back.  The  prompt- 
ness of  reaction  otherwise  makes  this  the  more 
striking. 

Extreme  Reactions. — In  single  stimuli  there  were  no 
extreme  reactions;  in  doable  stimuli  there  were  none 
except  in  the  second  interval  where  the  majority  were 
over  1.0  second. 

Consistency. — No  measure  as  patient  came  only 
once. 

Diminution  of  .Sensation. — ^All  responses  to  hot 
stimulation  were  'warm' ;  but  whether  this  indicated 


346 


Temperature  Sensitivity 


a  real  diminution  of  the  sensation  or  was  due  to 
patient's  slight  i<nowledge  of  English,  could  not  be 
determined.    No  diminution  of  cold  was  reported. 

Intensification. — Abdomen  and  back  occasionally 
gave  slight  reflexes  with  cold  stimulus. 

While  single  stimuli  gave  normal  reaction  to  both 
cold  and  hot,  in  double  stimuli  hot  seemed  to  be 
somewhat  interfered  with — being  markedly  delayed 
in  double  responses;  never  occurring  alone;  and 
showing  a  tendency  to  be  inhibited  altogether  on 
legs.  (In  preliminary'  practice,  it  tended  to  be  in- 
hibited also  on  left  arm.) 

The  disturbance  is  very  slight  but  general. 

PERIPHER.\L  NEURITIS 

In  one  of  the  four  cases  studied  no  distur- 
bance is  shown;  in  one,  it  is  shown  by  the 
number  of  H-C  responses,  and  single  re- 
sponses, and  their  increased  reaction-time; 
and  in  two  it  could  not  be  determined  whether 
there  was  any  disturbance  or  not.  Analyses 
of  the  cases  follow: 

Case  X\'III. — L.  R.;  age  17;  student;  in- 
telligence and  cooperation  very  good. 

Onset. — November,  1916,  median  and  ul- 
nar nerves  of  right  arm  cut  by  glass. 

Sensation. — Examination,  January  10, 
191 7:  Loss  of  touch  and  temperature  (or 
deep  hypesthesia)  over  palm  and  fingers, 
volar  surfaces;  and  second  and  third  pha- 
langes of  first,  second  and  third  fingers,  dorsal 
surface.  March  24,  1917:  Whole  palm  and 
volar  surface  of  fingers  hypesthetic  to  cold 
— more  on  palm  and  first  phalanges  than  on 
terminal  phalanges.  Palm  normal  to  warm 
and  hot.  Hypesthesia  to  cold  on  dorsal  sur- 
face of  fingers. 

Prelimin.\ry  Tests. — April  27,  1918:  Cold  was 
more  intense  on  median  than  on  ulnar  side  of  right 
palm — both  sides  being  more  sensitive  than  left 
palm.  Second  and  third  phalanges  of  first  and  second 
fingers  of  right  hand  were  more  sensitive  to  cold  than 
left.  Warm  felt  the  same  on  both  hands,  but  seemed 
a  little  slower  in  reaction  on  volar  surface  of  fingers 
of  right  hand. 

I.  Gross  Disturbanxe. — No  failure;  per^-ersion 
not  present. 

II.  General  Ch.^racter.  Type  of  Response. — 
Curve  is  entirely  normal  for  regions  tested. 


Median  Reaction-lime. — No  difference  is  apparent 
in  time  of  response  for  either  arm;  times  are  normal 
on  those  areas  upon  which  sufficient  tests  were  made 
to   be   reliable. 

Extreme  Reactions. — Rare. 

Consistency. — In  single  stimuli  consistency  was 
normal  in  both  type  and  time.  In  double  stimuli, 
while  consistency  is  normal  in  type,  there  is  a  slightly 
greater  fluctuation  in  time.  This  is  somewhat  greater 
on  right  arm  than  on  left — eighty-six  per  cent,  of 
areas  of  left  arm  had  a  range  under  .3  second,  fifty- 
six  per  cent,  on  right. 

Diminution. — All  responses  to  hot  stimuli  were 
'warm'.  (On  right  arm,  temperature  was  40°  to  41°; 
on  left,  one  series  was  40°  to  41°,  another  45°.  In 
one  instance,  sensation  'hot'  followed  .4  second 
later.)     No  diminution  of  cold  was  reported. 

Intensification. — No  evidence. 

The  method  of  the  experiment  shows  no  evidence 
of  disturbance,  although  the  introspective  report  of 
the  patient  in  the  preliminary  tests  show's  that  recov- 
er\-  is  not  yet  quite  complete. 

Case  XIX. — M.  F.;  age  19;  student;  in- 
telligence and  cooperation  good. 

Onset. — Median  nerve  of  left  arm  cut  by 
bullet  wound,  April,  1918. 

Sensation. — Described  in  history,  May, 
1 91 8:  Hypalgesia  and  hypesthesia  over  volar 
surface  of  thumb  and  first  and  second  fingers. 
Anesthesia  over  dorsal  surface  of  first  and 
second  fingers. 

Preliminary  Tests. — May  18,  1918:  Tempera- 
tures of  40°  and  18°  not  felt  on  median  surface  of 
left  hand  and  fingers,  either  dorsal  or  volar.  Ice 
felt  on  dorsal,  but  not  on  volar  median  surface. 
Temperature  of  45°  felt  slightly  at  times,  on  median 
palm  and  back  of  hand,  but  not  on  median  volar  sur- 
face of  fingers. 

I.  Gross  Disturbance. — Failures  to  react  were 
consistent — to  temperatures  of  40°  and  18°  on  dorsal 
and  volar  median  surface  of  left  hand  and  fingers, 
and  to  temperatures  of  16°  and  47°  on  volar  median 
surface  of  fingers.    No  perversion  occurred. 

II.  General  Character.  Type  of  Response. — 
Right  arm  shows  normal  distribution;  left,  a  major- 
ity of  H-C  responses,  and  some  single. 

Median  Reaction-time. — Tests  are  too  few  to  be 
very  reliable,  but  times  are  about  normal,  except  for 
H-C  responses  on  left  arm,  which  are  long  in  both 
inter\-als;  single  responses  on  left  arm  are  also  long. 

Extreme  Reactions. — Second  interval  of  H-C  re- 
sponses gives  a  majority  of  reactions  of  i.o  second  or 


Temperature  Sensitivity 


347 


more.  Single  responses  to  double  stimuli  also  give 
some  extreme  reactions. 

Consistency. — Cannot  be  measured,  as  patient 
came  only  once;  but  where  two  measures  of  a  kind 
were  obtained  for  any  area,  the  range  was  in  no  case 
as  much  as  i.o  second. 

Diminution  of  Sensation. — Some  diminution  of 
both  cold  and  hot  occurred  in  double  stimuli — more 
of  cold  than  of  hot,  and  more  on  left  arm  than  on 
right. 

Intensification. — No  evidence. 

The  disturbance  affects  the  entire  left  arm  which 
shows  more  single  responses,  more  H-C  responses, 
more  long  reactions,  and  more  diminution  of  inten- 
sity than  the  right.  The  deep  hypesthesia,  however, 
is  restricted,  and  seems  to  be  greater  for  cold  than 
for  hot. 

Case  XX. — H.  T.  (female),  age  20;  book- 
keeper;    intelligence    and    cooperation    very 


vidual  difTerence  not  shown  among  normal  subjects 
tested.  The  absence  of  single  responses  also  suggests 
normality. 

Case  XXI. — B.  P.  (female);  age  29;  house- 
wife;    intelligence    rather    low;     cooperation 


Onset. — Sudden  paralysis  of  right  side  of 
face  following  abscess  in  right  ear,  February, 
1917. 

Sensation. — Described  in  history,  Janu- 
ary, 191 8:     Normal  except  for  loss  of  taste. 

I.  Gross  Disturbance. — No  failure  to  react. 
Perversion  not  present. 

II.  General  Character.  Type  of  Response. — 
The  predominance  of  H-C  responses  on  upper  ex- 
tremities and  face  of  this  patient  led  to  a  test  of  the 
legs  also,  where  C-H  were  found  to  predominate. 
There  were  no  single  responses. 

Aledian  Reaction-time. — In  single  stimuli,  medians 
are  normally  prompt,  but  H  is  consistently  shorter 
than  C.  In  double  responses,  the  second  interval  is 
greater  than  normal,  particularly  in  H-C  responses. 

Extreme  Reactions. — These  occurred  only  in  second 
interval  of  double  responses — in  a  considerable  num- 
ber of  cases;  more  in  H-C  than  in  C-H  type. 

Consistency. — No  measure,  as  there  was  only 
one  observation,  but  the  indications  are  that  it  would 
be  high  for  the  H-C  type,  since  47.8  per  cent,  of  all 
areas  which  were  stimulated  twice  with  double  stim- 
uli gave  two  H-C  responses. 

Diminution  of  Sensation. — The  only  diminution 
occurred  with  hot  stimuli  on  cheeks. 

Intensification. — No  evidence. 

The  predominance  of  H-C  responses  on  upper 
extremities,  and  the  long  second  interval,  would 
certainly  point  to  a  disturbance  of  cold,  if  this  were 
suspected.  In  the  absence  of  any  reason  to  suspect 
a  disturbance,  one  must  assume  that  it  is  an  indi- 


Onset. — Sudden  paralysis  of  left  side  of 
face  following  pain  in  left  ear  consequent  on 
exposure  to  cold,  February  6,  1918. 

Sensation. — Described  in  history,  Febru- 
ary II,  1918:   "O.  K.  trifacial  distribution." 

I.  Gross  Disturbance. — No  failure  to  react. 
Perversion  not  present. 

II.  General  Character.  Type  of  Response.— 
Right  arm  and  face  have  more  single  responses  than 
normal:  H  on  arm  and  C  on  face.  Left  arm  has 
normal  distribution. 

Median  Reaction-time. — Medians  are  all  longer 
than  normal,  except  for  second  interval  of  C-H 
responses. 

Extreme  Reactions. — These  occurred  to  a  consider- 
able extent  in  first  interval  of  C-H  responses  and  in 
single  H  responses;  none  on  face. 

Consistency. — No  measure,  as  patient  came  only 
once. 

Diminution  of  Sensation. — Diminution  of  hot  oc- 
curred in  a  majority  of  responses  on  all  regions — 
slightly  more  with  double  than  with  single  stimulus. 
Once  the  perception  of  hot  followed  after  2.2  seconds. 

Intensification. — No  evidence. 

In  the  absence  of  more  than  one  observation,  par- 
ticularly with  a  patient  of  limited  intelligence,  it 
would  be  rash  to  assert  whether  or  not  the  long  reac- 
tion-times, and  the  single  responses  on  the  right  arm 
as  well  as  on  the  face,  indicated  a  disturbance  on 
either  region.  Unfortunately,  a  second  observation 
could  not  be  obtained. 

capsulo-thalamic  lesion 

Case  XXII.- — D.  L. ;  deaf  mute;  age  16; 
intelligence  and  cooperation  very  good  in 
spite  of  his  incapacity.  (Patient  was  able  to 
articulate  sufficiently  to  make  verbal  responses 
though,  of  course,  more  slowly  than  normal.) 

Onset. — About  two  years  before  test. 

Sensation. — Described  in  history,  October 
191 7:  "Hypersensitivity  to  pain  and  light 
touch  on  right  side  of  body."  No  mention  of 
temperature. 


348 


Temperature  Sensitivity 


I.  Gross  Disturbance. — There  were  some  fail- 
ures with  hot  stimuli  on  right  arm  and  on  right  side 
of  back;  and  with  double  stimuli  on  right  arm.  Per- 
version of  hot  is  almost  complete  on  right  side  of 
body  except  on  face,  where  perversion  of  cold  oc- 
curred. In  order  to  see  whether  patient  was  possibly 
getting  paradoxical  cold  sensations,  he  was  tested 
with  temperatures  of  36°  to  37°.  This  also  was  called 
'cold'  on  the  right  side,  and  'rather  hot'  on  left. 

II.  General  Character.  Type  of  Response. — 
C  predominates  on  right  side  (hot  not  felt  even 
alone)  but  C-H  responses  are  normally  frequent  (or 
nearly  so)  on  the  left  side.  Single  responses  are 
rather  more  frequent  than  usual  on  all  regions. 

Median  Reaction-time. — Reaction  is  generally 
longer  than  normal,  but  allowance  must  be  made  for 
the  speech  defect.  They  are  fairly  regular,  however, 
and  in  H-C  responses,  the  second  interval  is  almost 
normal. 


Extreme  Reactions. — In  spite  of  the  generally  long 
reaction-time  there  are  few  extreme  reactions  in 
single  stimuli.  In  double  stimuli  the  tendency  is 
greater,  particularly  for  cold  in  the  first  interval  or 
alone,  and  in  the  second  interval;  oftener  in  C-H 
than  in  H-C. 

Consistency. — In  single  stimuli,  there  is  consider- 
able inconsistency  in  type  with  hot  stimuli;  and 
fluctuation  in  time  with  both.  In  double  stimuli, 
no  type  reaches  normal  consistency;  but  C-H  and  C 
responses  occur  twice  with  a  fair  degree  of  frequency. 
Fluctuation  in  time  is  fairly  high. 

Diminution  of  Sensation. — No  evidence. 

Intensification. — Reflexes  were  frequent  on  right 
side  of  body — even  on  the  arm — for  both  sorts  of 
stimuli  and  sensation  was  rather  painful. 

The  disturbance  of  hot  is  profound  on  the  entire 
right  side  of  body;  but  allowing  for  the  speech  de- 
fect, the  left  side  is  probably  about  normal. 


[explanation  of  tables  will  be  found  on  page  372] 


In  this  and  the  following  tables,  the  regions  are  numbered  from  I-VIII  as  follows:   right  arm,  left  arm,  face, 
dorsal  surface  of  neck,  right  leg,  left  leg,  abdomen,  back. 

median  re.\ction-time  (in  seconds)  for  separate  and  double  stimuli  in  syringomyelia 

Case  I— P.  K. 


Double  Stimuli 

Separate  Cold  Stimuli 

Response  C-H 

Response  Cold 

Med. 

p.  E. 

No.  of  Cases 

1st  Interval 

2d  Interval 

No.  of  Cases 

Med. 

p.  e. 

No.  of  Cases 

3-0'  + 

Total 

Med. 

P.  E. 

Med. 

P.  E. 

1st  Int. 
3.o'4- 

2d    Int. 
l.o'  -1- 

Total 

3-0'-|- 

Total 

I 

2.4 

I-7-3-I* 

I 

2 

1-4 

.25 

2.0 

■75 

2 

6 

9 

2.1 

1.4-2.8 

2 

II 

1.8 

•25 

I 

II 

2.4 

.45 

3.5 

1.50 

2 

3 

5 

2.5 

.70 

2 

ID 

III 

IV 

1.2 

.00 

5 

2 

}.., 

.40 

•5 

.10 

I 

7 

1.8 

1. 7-1.9 

2 

V 

1-7 

•30 

5 

1.8 

.20 

•5 

.25 

3 

15 

VI 

1.8 

■05 

5 

1.4 

•30 

.6 

.30 

4 

10 

3.0 

2.2-3.8 

I 

2 

VII 

1-9 

1.6-5.4 

I 

3 

1-5 

.25 

.9 

1.20 

I 

2 

5 

2.1 

.35 

4 

VIII 

1.5 

.20 

5 

2.2 

1.8-2.6 

1.6 

1.20 

I 

2 

1.8 

.20 

7 

Totals 

3 

38 

5 

20 

53 

3 

27 

Separate  Hot 

Response  H-C 

Response  Hot 

I 

1.6 

•35 

II 

1-5 

I.2-I.9 

2.5 

.8-4.2 

I 

2 

2.1 

■35 

18 

II 

2.0 

•30 

13 

2.8 

.50 

1.9 

1.50 

2 

4 

6 

2.2 

•50 

10 

III 

IV 

14 
l-.S 

.20 
1. 2-1. 8 

7 
2 

1" 

1.4-3.4 

.5 

.4-3.6 

I 

I 

3 

I.I 

I 

V 

1-3 

■05 

6 

1.9 

1.8-2.0 

3 

VI 

l-.S 

.20 

6 

2.2 

.05 

.6 

.20 

I 

4 

1-9 

1.2-2.7 

2 

VII 

1-4 

1.3-2.7 

4 

1.5 

1. 2-1. 8 

.4 

.3-5 

2 

2-5 

I 

VIII 

1.8 

•15 

4 

1.6 

6.0 

I 

I 

2.0 

1.6-2.4 

2 

Tc 

tals 

1 

53 

3 

8 

18 

1    37 

*  Total  range  is  given  with  less  than  four  cases. 


Temperature  Sensitivity 

TABLE  I.  (Syringomyelia  continued) 

Case  II— E.  Wi. 


349 


Separate  Cold  Stimuli 

Double  Stimuli 

Response  C-H 

Response  Cold 

Med. 

P.E. 

No.  of  Cases 

I  St  Interval 

2d  Interval 

No.  of  Cases 

Med. 

P.E. 

No.  of  Cases 

3.0'+ 

Total 

Med. 

P.E. 

Med. 

P.E. 

ist  Int. 
3.0'  + 

2d    Int. 
l.o'  + 

Total 

30'  + 

Total 

I 

1.2 

•25 

12 

1-3 

.20 

•4 

•05 

I 

I 

24 

11 

1-3 

•95 

2 

12 

I.I 

.20 

•5 

.10 

I 

7 

,V3 

1-75 

4 

(y 

III 

IV 

1.2 
I.I 

.20 

•9-1  3 

6 

2 

t" 

.20 

•4 

.20 

2 

8 

I.O 

I 

V 

I.I 

.20 

6 

1.6 

•25 

•7 

.80 

I 

6 

16 

1.4 

I-3-I-7 

3 

VI 

1.2 

.00 

5 

1^3 

•25 

.8 

•50 

7 

16 

1.6 

•25 

I 

8 

VII 

•9 

•05 

4 

1^3 

•25 

.6 

.20 

2 

12 

Vlll 

I.I 

.lO 

4 

I.I 

•15 

•4 

•05 

9 

•9 

I 

Totals 

2 

51 

2 

19 

92 

5 

19 

Separate  Hot 

Response  H~ 

; 

Response  Hot 

I 

I.I 

.20 

I 

9 

!•? 

•25 

■4 

■05 

7 

2.1 

I 

II 

2.0 

I.OO 

2 

7 

2^5 

1.6-3.4 

.8 

.6-1.1 

I 

I 

2 

3.7 

I 

I 

III 

IV 

I.O 
I.O 

.10 

.9-1.2 

6 

2 

1" 

.10 

I.I 

.10 

3 

4 

1.2 

1.4 

1. 4-1. 4 

I 
2 

V 

1-3 

.10 

6 

!•? 

.10 

.6 

•05 

4 

1-3 

I 

VI 

1-3 

•15 

5 

VII 

I.O 

•05 

4 

1.6 

1. 1-2. 1 

1.2 

•5-2^o 

I 

2 

2.8 

1.2-4.4 

I 

2 

VIII 

2.2 

1. 1-2.7 

3 

13 

•25 

•4 

•05 

I 

6 

Totals 

3 

42 

I 

6 

25 

2 

8 

Case  III— A.  C. 


Double  Stimuli 

Response  C-H 

Response  Cold 

Med. 

P.E. 

No.  of  Cases 

1st  Interval 

2d  Interval 

No.  of  Cases 

Med. 

P.E. 

No.  of  Cases 

3.0'  + 

Total 

Med. 

P.E. 

Med. 

P.E. 

1st  Int. 
3.0'  + 

2d    Int. 
i.o'-f 

Total 

3.0'  + 

Total 

I 

3^o 

I 

I 

II 

3^1 

2.4-3.8* 

I 

2 

III 

1^5 

1. 3-1. 6 

3 

2.2 

I 

IV 

4.6 

I 

I 

V 

3^1 

2.0-4.8 

2 

3 

2.6 

2.5-2.7 

32 

I- 5-5-0 

2 

2 

VI 

'•7 

I  •3-4^3 

I 

3 

VII 

39 

3.8-4.1 

2 

2 

2.9 

1.6-4.3 

I 

3 

VIII 

t3^2 

2.7-3.8 

1 

2 

Totals 

8 

16 

2 

2 

2 

5 

Separate  Hot 

Response  H-C 

Response  Hot 

I 

4-5 

.90 

4 

4 

4.8 

1^35 

5 

6 

11 

49 

2.8-5.2 

2 

3 

7.5 

6.4-8.6 

2 

2 

111 

2.6 

I.4-3-0 

I 

3 

2.2 

3^6 

I 

I 

2.0 

.00 

4 

IV 

9.6 

I 

I 

V 

2.1 

1.6-2.4 

3 

2.6 

.60 

4 

10 

VI 

2.0 

1.6-2.8 

3 

2.2 

•30 

2 

12 

VII 

4.2 

2.9-55 

I 

2 

4.0 

•30 

5 

5 

VIII 

t2.I 

1.8-2.4 

2 

4.1 

•90 

3 

4 

Totals 

8 

20 

I 

I 

22 

44 

*  Total  range  given  with  less  than  four  cases. 

t  Areas  stiinulated  on  back  were  shoulder  blades,  since  usual  areas  did  not  respond  at  all. 


350 


Temperature  Sensitivity 

TABLE  I.  (Syringomyelia  continued) 

Case  IV— L.  A. 


Separate  Cold  Stim 

Uli 

Double  Stimuli 

Response  C- 

H 

Respo 

nsc  Cole 

Med. 

p.  E. 

No.  of  Cases 

1st  Interval 

2d  Interval 

No.  of  Cases 

Med. 

P.  E. 

No.  of  Cases 

3.0'  + 

Total 

Med. 

P.  E. 

Med. 

P.  E. 

1st  Int. 
3.0'  + 

2d    Int. 
l.o'  + 

Total 

3-0  ■  + 

Total 

I 

1-5 

.10 

5 

I.O 

.8-1.2 

.6 

■5-7 

2 

3-0 

1.3-40 

2 

3 

11 

1.7 

•15 

I 

6 

1.4 

1.4-2.4 

■3 

•3--5 

3 

17 

1.7-2.0 

3 

111 

IV 

2.2 
17 

■•3-5-1 

I 

3 

I 

i- 

1.6-2.0 

2.1 

.6-3.6 

I 

2 

2.2 

2.0-2.5 

2 

V 

1-3 

1. 3-1. 4 

2 

1.8 

•25 

4 

■05 

I 

7 

2.9 

I 

VI 

2.2 

I -5-24 

3 

1-9 

■30 

■5 

•05 

I 

4 

1.8 

I 

Vll 

2-5 

2.4-2.6 

2 

1-5 

.10 

4 

.10 

5 

VIII 

1-3 

I 

1-5 

1. 4-1. 7 

4 

4-4 

2 

Totals 

2 

23 

3 

25 

2 

10 

Separate  Hot 

Response  H-C 

Respon 

eHot 

I 

14 

.40 

6 

1.8 

.60 

.8 

■15 

2 

6 

2.1 

75 

I 

5 

11 

1-5 

■05 

6 

1.8 

■30 

•5 

•15 

I 

I 

7 

17 

1.0-2.0 

3 

III 

1.2 

I.I-I.5 

3 

2.0 

1. 1-2. 9 

2 

IV 

1.8 

I 

1.6 

I-5-I-7 

2.6 

2.6-2.7 

2 

2 

V 

1-7 

1.6-2.9 

3 

2.0 

1.9-2.2 

.6 

■5-7 

2 

4.0 

I 

I 

VI 

1.6 

.9-1.9 

3 

1.8 

.10 

1-3 

•50 

2 

5 

2.6 

2.2-3.1 

1 

2 

VII 

2.0 

1.6-2.5 

2 

1.6 

1.2-2.4 

4 

.4-2.8 

I 

3 

VIII 

2.1 

1.4-2.8 

2 

1.6 

.20 

4 

.05 

6 

Totals 

26 

I 

8 

31 

3 

13 

Case  V— J  CI. 


Separate  Cold  Stimuli 


I 

II 

III 

IV 

V 

VI 

VII 

VIII 


•15 

I.0-I.2* 

•05 

•05 

1.6-1.8 

.8-1.1 


•05 
•05 


1. 0-1.3 
I.I-I.6 


■9-1-3 

2.1-2.3 


I 

II 
III 
IV 

V 
VI 
VII 
VIII 


•05 
■9-9 

.10 

.10 

•15 
.10 


•05 
i.i-i. 
.10 
.10 
.20 
-25 


■  Total  range  given  with  less  than  four  cases. 


Temperature  Sensitivity 

TABLE  I.  (Syringomyelia  concluded) 
Case  VI— B.  T.f 


351 


Separate  Cold  Stim 

uli 

Double  Stimuli 

Response  C-H 

Response  Cold 

Med. 

p.  E. 

No.  of  Cases 

1st  I 

nterval 

2d  Interval 

No.  of  Cases 

Med 

P.  E. 

No.  of  Cases 

3.0'  + 

Total 

Med. 

P.  E. 

Med. 

P.  E. 

3.0'  + 

I.O' 

Total 

3.o'  + 

Total 

I 

2.2 

1.6-2.9 

3 

11 

44 

I 

I 

III 

2.1 

I 

17 

4 

I 

IV 

2.0 

I 

V 

1-7 

1.5-2.0 

2 

1.9 

•25 

4 

■05 

I 

5 

VI 

2.4 

I 

1.8 

•25 

•5 

.00 

4 

2.4 

I 

Vll 

1-3 

I 

1.4 

1. 2-1. 8 

4 

4-4 

3 

VUI 

2.1 

I 

1-7 

1. 7-1.9 

4 

4--,S 

3 

Totals 

I 

8 

1 

16 

4 

Separate  Hot 

Response  H-C 

Response  Hot 

I 

1-7 

1.7-2.8 

3 

3-3 

2..-4.,S 

I 

2 

11 

1.8 

I 

2.3 

1.9-4.8 

I 

3 

111 

1-9 

1.8-2. 1 

2 

2.2 

■5 

I 

1.6 

I 

IV 

(No 

Stimuli) 

V 

2.6 

I 

3-0 

I 

I 

VI 

2.4 

2.2-2.6 

2 

,S.8 

•7 

I 

I 

VII 

1.8 

I 

24 

.8 

I 

VIII 

(No 

stimuli) 

24 

I 

Totals 

10 

I 

3 

3 

8 

TABLE  2 

MEDIAN  REACTION-TIME  FOR  SEPARATE  AND  DOUBLE  STIMULI  IN  TABES  DORSALIS 

Case  VII— G.  C. 


Separate  Cold  Stimuli 

Double  Stimuli 

Response  C-H 

Response  Cold 

Med. 

P.  E. 

No.  of  Cases 

1st  Interval 

2d  Interval 

No.  of  Cases 

Med. 

P.  E. 

No.  of  Cases 

2d     Int 

3.0'  + 

Total 

P.  E. 

3.0  ■  + 

I.0'  + 

Total 

3.0'  + 

Total 

I 

2-3 

•35 

2 

13 

34 

•50 

•7 

.40 

6 

2 

7 

2.6 

•65 

3 

7 

11 

2.3 

.40 

I 

13 

2.6 

•30 

■5 

•15 

2 

13 

3^o 

.20 

2 

4 

111 

2.1 

.20 

I 

6 

1 

4.4 

IV 

1.8 

1.6-2.0* 

2 

p.. 

■35 

.6 

•45 

3 

I 

7 

V 

2.1 

•30 

4 

3-4 

2.8-3.5 

.6 

.6-.8 

2 

3 

3^0 

3^o-3^i 

2 

2 

VI 

2.6 

•35 

I 

4 

3^1 

2.6-4.6 

1^7 

1.2-2.0 

2 

3 

3 

3^9 

.80 

3 

4 

Vll 

2.0 

2.0-2.2 

3 

VIII 

1.6 

•15 

4 

3-9 

■25 

1.0 

.20 

3 

2 

4 

3-6 

•25 

5 

5 

Totals 

5 

49 

18 

8 

37 

16 

23 

Separate  Hot 

Response  H-C 

Respor 

se  Hot 

I 

2.0 

•50 

I 

13 

2.8 

•25 

.6 

•15 

5 

2 

12 

2.0 

•50 

I 

5 

11 

2.0 

.20 

13 

3-1 

•65 

1.0 

•30 

6 

5 

18 

2.9 

I  •4-3  •  7 

I 

3 

HI 

1. 9 

.10 

4 

1 

IV 

1-3 

1.1-1.6 

p.. 

•55 

•7 

•15 

2 

2 

5 

1.6 

•  •5-i^8 

2 

V 

2-5 

.40 

2 

7 

4.1 

•75 

2.0 

1.40 

4 

2 

4 

3-6 

•65 

6 

10 

VI 

3-1 

•75 

4 

6 

3-3 

•25 

2.1 

•30 

4 

3 

4 

3^1 

•30 

5 

9 

Vll 

1.4 

.00 

4 

24 

.40 

•9 

•75 

3 

5 

10 

2.2 

1.3-2.2 

3 

VUI 

1-3 

■05 

4 

2.9 

•30 

.7 

.10 

2 

I 

4 

1.2 

.9-2.0 

3 

Totals 

7 

53 

26 

20 

57 

13 

35 

t  B.  T.  came  only  once;  as  the  test  was  planned  ioifour  observations,  the  number  is  too  small  to  make  conclusions  more 
than  suggestive.  *  Total  range  given  with  less  than  four  cases. 


352 


Temperature  Scnsiti\'ity 
TABLE  2.  (Tabes  Dorsalis  continued) 


Case  VIII— P.  O. 


Separate  Cold  Stimuli 

Double  Stimuli 



Response  C-H 

Response  Cold 

Med. 

P.  E. 

No.  of  Cases 

1st  Interval 

2d  Interval 

No.  of  Cases 

Med. 

p.  E. 

No.  of  Cases 

3.0'-f 

Total 

Med. 

P.  E. 

Med. 

P.  E. 

1st   Int. 
3.0'  + 

2d    Int. 
i.o'  + 

Total 

3.0'-f 

Total 

I 

1.2 

.00 

I 

13 

1-5 

■50 

.8 

•50 

I 

5 

II 

3^0 

■35 

4 

7 

11 

I.O 

.10 

12 

1-3 

•30 

2.5 

•55 

I 

6 

8 

1.0 

.20 

I 

5 

III 

IV 

1-3 

2.1 

•30 

•8-3.4 

I 

6 

2 

1- 

•I."; 

I.I 

•55 

3 

5 

I.I 

•05 

4 

V 

1.0 

•05 

6 

1-7 

.40 

1.0 

•50 

2 

6 

12 

1^4 

.20 

2 

9 

VI 

1.2 

■25 

6 

1.6 

.10 

1.0 

•50 

3 

8 

1.6 

.40 

2 

II 

VII 

I.I 

.40 

4 

1.2 

.40 

•5 

.00 

4 

6.6 

1.6-8.6 

2 

3 

VIII 

.8 

.5-.8 

3 

1-7 

1.3-2.2 

2.2 

.6-3.8 

I 

2 

1-7 

•05 

I 

5 

Totals 

2 

52 

4 

24 

50 

12 

44 

Separate  Hot 

Response  H-C 

Response  Hot 

I 

1.2 

.00 

12 

1.8 

•35 

•5 

•55 

I 

3 

9 

15 

■25 

6 

11 

•9 

.10 

12 

1^4 

•45 

•5 

•65 

I 

5 

12 

2^4 

.70 

4 

6 

III 
IV 

I.I 
.6 

•  15 
.6-.7 

6 

2 

1- 

■05 

1.0 

.60 

2 

2 

4 

2.4 
1.3 

1.2-1.4 

I 
2 

V 

1.0 

•05 

6 

1.6 

1. 6-1. 7 

■3 

•3-4 

2 

5^6 

I 

I 

VI 

1.2 

.10 

6 

2.0 

2.0-2.3 

•4 

•4-^5 

I 

2 

1-9 

1.3-4.6 

I 

3 

VII 

1.0 

.00 

4 

1.6 

•45 

•4 

•05 

I 

6 

17 

I  •3-32 

I 

3 

\111 

•9 

•05 

4 

2.0 

.8 

I 

1.4 

.20 

9 

Totals 

52 

5 

II 

36 

7 

31 

Case  IX— J.  Co. 


Double  Stimuli 

Response  C- 

H 

Response  Cold 

Med. 

p.  E. 

No.  of  Cases 

1st  Interval 

2d  Interval 

No.  of  Cases 

Med. 

p.  E. 

No.  of  Cases 

3.0'  + 

Total 

Med. 

p.  E. 

Med. 

P.  E. 

ist  Int. 
3.0'  + 

2d    Int. 
l.o'  + 

Total 

3-0'  + 

Total 

I 

l.o 

•15 

14 

I.I 

•05 

•4 

.00 

5 

1-5 

.20 

7 

11 

1.0 

.10 

14 

13 

.10 

•5 

•05 

16 

■9 

.9-1.0 

2 

111 

IV 

1.0 
1.0 

•15 
.9-1.2* 

7 
2 

1m 

.10 

.6 

•05 

9 

V 

I.I 

.20 

6 

1^4 

•15 

•7 

.40 

10 

1^3 

•15 

12 

VI 

I.I 

.10 

6 

1.2 

.20 

.6 

.20 

6 

13 

.20 

16 

VII 

1.0 

.00 

4 

I.I 

•15 

■5 

■15 

I 

6 

6.8 

I 

I 

VI 11 

1.0 

1. 0-1.6 

3 

1.4 

•25 

•5 

.10 

5 

13 

i^3-i.4 

2 

Totals 

56 

I 

9 

57 

I 

40 

Separate  Hot 

Response  H- 

-C 

Response  Hot 

I 

i.i 

.10 

12 

1^3 

.10 

20 

II 

I.I 

.10 

14 

13 

•05 

•3 

.10 

I 

8 

13 

.20 

5 

III 

IV 

1.0 
1.0 

•05 

I.O-I.O 

6 

2 

] 
,^1.2 

I.I-I.4 

2^4 

2.2-2.7 

2 

2 

1.0 

1.4 

•05 

4 

I 

V 

1-7 

■75 

2 

7 

1.6 

1.0 

I 

I 

2.7 

I 

VI 

1-3 

.10 

I 

5 

1.2 

I 

VII 

1.4 

.20 

I 

5 

17 

•9 

I 

14 

.20 

I 

8 

VIII 

1.5 

•  15 

4 

15 

1. 4-1. 6 

1.0 

..5-1.6 

I 

2 

1^5 

•25 

8 

Totals 

4 

55 

~ 

5 

«4 

I 

48 

'  Total  range  given  with  less  than  four  cases. 


Temperature  Sensitivity 

TABLE  2.  (Tabes  Dorsalis  concluded) 
Case  X— L.  F. 


353 


Double  Stimuli 

Response  C-H 

Response  Cold 

Med, 

p.  E. 

No.  of  Cases 

1st  Interval 

2d  Interval 

No.  of  Cases 

Med. 

p.  E. 

No.  of  Cases 

3.0'  + 

Total 

Med. 

P.  E. 

Med. 

P.  E. 

1st  Int. 
.1.0'  + 

2d    Int. 

I.0'  + 

Total 

3.0'  + 

Total 

I 

I.O 

•30 

9 

1.2 

■30 

.6 

■15 

7 

1.6 

1. 00 

2 

6 

II 

1.6 

.65 

8 

1.6 

.40 

.6 

.10 

I 

5 

1-7 

-25 

6 

III 

IV 

I.O 
1.0 

•25 
.8-1.2 

6 
2 

1- 

2.4-2.8 

1.4 

•4-2-5 

I 

2 

V 

1.4 

I-3-I.7 

3 

•9 

.8-1.0 

•4 

•4--5 

2 

2.1 

.00 

4 

Vi 

1-5 

I.O-I.5 

3 

I.O 

.7-1.2 

•3 

-3--4 

3 

1-9 

1.4-2.2 

3 

VII 

I.O 

.8-1.1 

3 

VIII 

1-9 

1. 8-2. 1 

2 

1.8 

.8 

I 

Totals 

36 

2 

20 

2 

19 

Separate  Hot 

Response  H-C 

Response  Hot 

I 

1-4 

.60 

I 

16 

1.6 

•15 

•4 

-05 

2 

II 

11 

1.2 

•50 

10 

1.4 

■30 

•4 

•05 

2 

14 

III 

IV 

•9 
I.I 

•05 
•9-1-4 

6 

2 

},.. 

•15 

1-3 

-75 

6 

10 

V 

2.3 

1.6-3.0 

I 

2 

I.I 

•30 

•4 

-05 

I 

12 

VI 

1-7 

.00 

I 

4 

I.O 

.40 

•4 

-05 

12 

VII 

I.I 

I.O-I.I 

3 

•9 

•05 

•4 

-05 

I 

8 

I.O 

-15 

4 

VIII 

I.I 

1.1-1.2 

3 

.8 

•25 

•4 

.10 

I 

7 

.8 

•05 

4 

Totals 

3 

46 

13 

74 

8 

Case  XI— H.  D. 


Double  Stimuli 

Response  C-H 

Response  Cold 

Med. 

P.  E. 

No.  of  Cases 

1st  Interval 

2d  Interval 

No.  of  Cases 

Med. 

p.  E. 

No.  of  Cases 

3.0'  + 

Total 

Med. 

p.  E. 

Med. 

p.  E. 

1st  Int. 
3-0'  + 

2d    Int. 

I.0'  + 

Total 

3-o'  + 

Total 

I 

1.6 

-35 

I 

13 

1-4 

.10 

1-5 

I-I5 

3 

5 

2.6 

-50 

3 

9 

II 

1-9 

.20 

I 

12 

3-2 

1.8 

I 

I 

I 

2.0 

-85 

4 

13 

III 

1.6 

.20 

6 

1 

1.8 

.20 

I 

7 

IV 

2.2 

1.6-2.9* 

2 

p.o 

2.7 

I 

I 

3-2 

I 

I 

V 

1.8 

.20 

I 

6 

2.1 

-25 

2 

12 

VI 

2.1 

.10 

6 

2.6 

-35 

3 

13 

Vll 

1-7 

.40 

5 

3-6 

1-9-5-4 

2.1 

1.6-2.6 

I 

2 

2 

2.4 

-55 

3 

9 

VIll 

2-3 

.10 

4 

2.8 

.70 

4 

10 

Totals 

3 

54 

2 

7 

9 

21 

74 

Separate  Hot 

Response  H-C 

Response  Hot 

1 

1.6 

•30 

12 

7-3 

•5 

I 

I 

2.2 

-45 

2 

9 

II 

1-7 

.20 

12 

3-7 

3-7-3-8 

2.6 

-5-4-8 

2 

I 

2 

3-5 

I-15 

4 

8 

III 

2.3 

.70 

6 

1 

IV 

1.6 

I -3-1 -9 

2 

|4-4 

3-6 

i 

I 

I 

2-7 

2.7-2.8 

2 

V 

2-7 

.90 

2 

5 

3-2 

4-3 

I 

I 

I 

3-0 

-65 

3 

5 

VI 

2.0 

•45 

I 

6 

3-5 

.70 

3 

5 

Vll 

1.6 

-25 

5 

4-9 

3-7-6-6 

2 

2 

VIll 

1-3 

-05 

4 

2-9 

2.0-3.8 

I 

2 

Totals 

3 

52 

5 

3 

5 

15 

33 

*  Total  range  given  with  less  than  four  cases. 


354 


Temperature  Sensitivity 


TABLE  3 

MEDIAN  REACTION-TIME  FOR  SEPARATE  ANT)  DOUBLE  STIMULI  IN  MULTIPLE  SCLEROSIS 

Case  XII— E.  Wa. 


Double  Stimuli 

,h 

Re 

ponse  H-C 

Response  Cold 

Med. 

P.  E. 

No.  of  Cases 

1st  Interval 

2d  I 

iterval 

No.  of  Cases 

Med. 

P.  E. 

No.  of  Cases 

3.0'  + 

Total 

Med. 

P.  E. 

Med. 

P.  E. 

1st  Int. 
3.0'  + 

2d    Int. 

Total 

3.0 '4- 

Total 

I 

1.2 

.lO 

M 

1.6 

1.4-2.4 

3^3 

1.2-4.4 

3 

3 

11 

1.2 

.10 

12 

1.6 

•15 

1.2 

2.20 

3 

5 

1.2 

I 

III 

1-3 

•50 

7 

I 

IV 

1.6 

I-5-I-7* 

2 

J 

V 

1.2 

.ID 

6 

1.4 

.20 

1.4 

2.50 

6 

7 

1-5 

.20 

4 

VI 

1.6 

.20 

7 

1-5 

•25 

2.7 

1.50 

5 

5 

15 

•25 

I 

12 

VII 

1-3 

■05 

4 

1-9 

1.4-2.5 

2.4 

2.2-4.8 

3 

3 

1^7 

'■5-3^2 

I 

3 

VIII 

1.2 

.10 

4 

1.4 

■05 

1-4 

■85 

2 

4 

1.2 

4 

Total? 

56 

22 

27 

2 

24 

Separate  Hot 

Response  H-C 

Response  Hot 

I 

1-3 

.10 

12 

1-4 

•25 

3.0 

125 

10 

10 

1-4 

.20 

19 

11 

1.2 

.lO 

12 

1-3 

.20 

2-7 

1-45 

10 

10 

1^4 

.20 

I 

17 

III 

IV 

1.2 
1.2 

•25 

I.I-I.3 

6 
2 

}m 

•25 

2^4 

1-25 

8 

8 

1^5 

1^3 

.10 

4 

I 

V 

1-4 

•15 

7 

1.8 

1. 6-2. 1 

5^9 

4.8-7.0 

2 

2 

2.0 

•15 

I 

12 

VI 

1.4 

■25 

I 

6 

1.6 

6.1 

I 

I 

2.6 

1. 00 

3 

6 

VII 

1-7 

.10 

4 

'■7 

1.6-5.6 

1-3 

1. 0-1.9 

I 

3 

3 

2.2 

1.8-2.4 

3 

VIII 

1.4 

•05 

4 

••4 

.20 

2.8 

1.65 

5 

7 

1-3 

I 

Totals 

I 

53 

1      I 

39 

41 

5 

60 

Case  XIII— J.  0- 

Double  Stimuli 

' 

Response  C-H 

Respon 

se  Cold 

Med. 

p.  E. 

No.  of  Cases 

1st  Interval 

2d  Interval 

No.  of  Cases 

Med. 

P.  E. 

No.  of  Cases 

3.0'  + 

Total 

Med. 

P.  E. 

Med. 

P.  E. 

1st   Int. 
3-0-  + 

2d    Int. 
i.o'  + 

Total 

3.0'  + 

Total 

I 

■9 

.10 

12 

■9 

.10 

.8 

•45 

9 

19 

■9 

•05 

8 

II 

8 

.05 

12 

•9 

.20 

.8 

.20 

4 

II 

•9 

.10 

16 

III 
IV 

I 

9 
I 

.10 

I.0-I.3 

6 
2 

}■« 

•05 

1.6 

•75 

3 

5 

.8 

.8-1.1 

3 

V 

I 

3 

.10 

6 

i.i 

.00 

1-5 

.20 

4 

4 

1.2 

.10 

14 

VI 

I 

2 

.00 

6 

I.I 

.10 

1.6 

.80 

7 

10 

1.2 

•05 

10 

VII 

8 

•05 

4 

.8 

•05 

.6 

■30 

4 

14 

.8 

.8-8 

2 

VIII 

9 

•  15 

4 

.8 

.6-1.0 

3.1 

2.5-3-8 

2 

2 

.8 

.00 

14 

Totals 

52 

33 

65 

67 

Separate  Hot 

Response  H-C 

Respo 

nse  Hot 

I 

•9 

•05 

12 

1-5 

.20 

6 

n 

I.O 

•05 

12 

1^3 

•15 

5 

III 

.8 

•05 

6 

1.0 

.10 

5 

IV 

1.0 

.9-1.1 

2 

1.4 

1.0-1.5 

3 

V 

1^4 

.20 

8 

1.6 

•55 

I 

5 

VI 

1.4 

.40 

7 

2.4 

2.4-2.6 

3 

VII 

1.2 

•05 

4 

VIII 

I.I 

•05 

4 

Totals 

55 

1 

27 

*  Total  range  given  with  less  than  four  cases. 


Temperature  Sensitivity 
TABLE  3.    (Multiple  Sclerosis  continued) 


355 


Case  XIV— G.  P. 


Separate  Cold  Stimuli 

Double  Stimuli 

Response  C-H 

Response  Cold 

Med. 

r.  E. 

No.  of  Cases 

1st  Interval 

2d  Interval 

No.  of  Cases 

Med. 

P.  E. 

No.  of  Cases 

3.0'  + 

Total 

Med. 

p.  E. 

Med. 

p.  E. 

1st  Int. 
.1.o'  + 

2d    Int. 
i.o'-f 

Total 

3.0'  + 

Total 

I 

13 

.10 

14 

1-4 

■05 

•5 

■30 

6 

22 

1.9 

1.3-2.8 

3 

II 

1.2 

.10 

13 

1-3 

•35 

■5 

.10 

3 

20 

1^7 

I 

III 

IV 

1.2 
I-.S 

.00 
1.2-1.8* 

6 
2 

1 
(I.4 

•15 

•4 

.10 

3 

15 

V 

1.6 

■45 

6 

1.9 

•50 

.6 

.40 

2 

3 

9 

••7 

•50 

12 

VI 

I-.-? 

•30 

5 

1.6 

•  15 

I.O 

•30 

4 

7 

1.8 

.20 

15 

VII 

1.2 

1.0-2.0 

3 

1-4 

•30 

•5 

•15 

2 

4 

1^3 

I.I-I.6 

2 

VIII 

l-.S 

•13 

4 

1.4 

•15 

.6 

•15 

4 

10 

1.6 

1. 2-1. 6 

3 

Totals 

53 

1     2 

25 

87 

36 

Separate  Hot 

Response  H-C 

Response  Hot 

I 

i-.S 

■15 

13 

1.8 

1.7-2.0 

•5 

.5-^6 

2 

2.0 

.10 

5 

II 

1.2 

.10 

13 

1.6 

•30 

•9 

.60 

5 

II 

III 

1.2 

.20 

7 

2.1 

•4 

I 

IV 

1-3 

1. 2-1. 4 

2 

V 

1.4 

.10 

5 

2.1 

2.0-3.0 

1.6 

I-I-3-4 

I 

3 

3 

VI 

14 

•35 

7 

1.8 

1.7-2.0 

2-7 

■7-4-7 

I 

2 

VII 

1-3 

■05 

5 

1.8 

I 

VIII 

1-5 

.00 

4 

1-7 

1.4-2. 1 

•5 

.5-1.2 

I 

3 

Totals 

56 

I 

10 

22 

6 

Case  XV— J.  T. 


jli 

Double  Stimuli 

Separate  Cold  Stim 

Response  C-H 

Response  Cold 

Med. 

p.  E. 

No.  of  Cases 

1st  Interval 

2d  Interval 

No.  of  Cases 

Med. 

p.  E. 

No.  of  Cases 

3.o'  + 

Total 

Med. 

P.  E. 

Med. 

P.  E. 

1st  Int. 
3.0'  + 

2d    Int. 

Total 

3.0'  + 

Total 

I 

1.2 

.20 

I 

15 

I^3 

•35 

•4 

.00 

I 

8 

II 

1-4 

.20 

14 

I.I 

.10 

•4 

9 

III 

IV 

1.2 
1.0 

■25 
I.O-I.I 

9 

2 

1- 

.20 

.6 

•30 

I 

3 

9 

1-3 

1. 2-1 .8 

3 

V 

1.6 

.10 

8 

1^5 

.10 

1.2 

.80 

6 

10 

2.0 

1.8-2.2 

2 

VI 

1.6 

•05 

I 

8 

1.6 

•35 

.8 

•35 

3 

9 

2^7 

1.8-3.6 

I 

2 

VII 

1-3 

.00 

4 

I.I 

•  15 

•5 

•50 

I 

7 

VIII 

1.0 

.10 

6 

I.I 

■05 

■4 

.00 

I 

4 

Totals 

2 

66 

I 

15 

56 

I 

7 

Separate  Hot 

Response  H-C 

Response  Hot 

I 

1.0 

•05 

14 

I^5 

■25 

2.3 

•65 

6 

6 

1^3 

.10 

16 

II 

1.0 

.10 

15 

1-3 

•30 

.6 

•75 

3 

7 

1.4 

■05 

14 

HI 

1^3 

•65 

I 

7 

2.1 

2.0-2.3 

2.1 

1.0-3.2 

2 

2 

1.8 

I 

IV 

1.0 

I.O-I.O 

3 

1-3 

I  •3-1^3 

2 

V 

1^7 

.80 

I 

7 

1.8 

1.0-2.6 

1-5 

.6-2.4 

X 

2 

2.0 

•75 

3 

10 

VI 

1-4 

•25 

8 

2.8 

2.4-3^2 

■9 

.6-1.2 

I 

I 

2 

2.4 

.40 

I 

10 

VII 

1.0 

•15 

4 

19 

•30 

2.5 

■30 

3 

4 

1^3 

■15 

8 

VIII 

1.0 

.00 

4 

1-3 

1. 2-1. 4 

■4 

■4-^5 

3 

1.2 

■25 

9 

Totals 

2 

62 

I 

16 

26 

4 

70 

'  Total  range  given  with  less  than  four  cases. 


356 


Temperature  Sensitivity 

TABLE  3.  (Multiple  Sclerosis  concluded) 
CaseXVI— I.  R.f 


Double  Stimuli 

Response  C-H 

Response  Cold 

Med. 

p.  E. 

No.  of  Cases 

1st  I 

iter\*al 

2d  Inten'al 

No.  of  C 

ses 

Med. 

P.  E. 

No.  of  Cases 

3.0'  + 

Total 

Med. 

P.  E. 

Med. 

P.  E. 

1st  Int. 
3.0'  + 

ad    Int. 

I.0'  + 

Total 

3.0'  + 

Total 

1 

I.I 

•05 

5 

1.4 

I.I-I.6 

•5 

•4--5 

3 

II 

1.2 

•05 

4 

1-5 

•05 

■9 

■25 

2 

4 

III 

IV 

I.O 

1-3 

■9-1-3* 

3 

I 

}.-, 

1.2-2.2 

.6 

•4--7 

3 

V 

1.4 

1. 2-1. 6 

3 

1-5 

.10 

.6 

.10 

I 

4 

1.6 

I.6-1.6 

2 

VI 

2.2 

1.4-2.6 

3 

1-9 

I-I-3-7 

.8 

.6-.9 

I 

3 

I.I 

.9-2.4 

3 

VII 

1.0 

I.O-I.I 

2 

1-3 

•05 

.6 

.10 

4 

VIII 

1.0 

I 

1.4 

1. 2-1. 7 

■9 

•5-1  ^3 

I 

2 

1.6 

I 

Totals 

22 

I 

4 

23 

6 

Separate  Hot 

Response  H-C 

Response  Hot 

I 

1.0 

■05 

6 

1-3 

■45 

1-5 

.85 

5 

7 

1-3 

1. 2-1. 4 

2 

II 

1.2 

I.I-I.3 

2 

I.I 

■25 

•5 

.00 

I 

5 

1-4 

I 

III 

I.O 

.8-1.3 

3 

IV 

(No 

stimuli) 

1.6 

•4 

I 

V 

1.6 

1. 4-1. 8 

2 

2.2 

.6 

I 

VI 

2.2 

I-3-2-3 

3 

VII 

I.O 

I.O-I.O 

2 

VIII 

I.O 

I 

1.6 

I 

Totals 

19 

6 

14 

4 

Case  XVII— J.  B.f 

Double  Stimuli 

Separate  Cold  Stimuli 

Resi>onse  C-H 

Response  Cold 

Med. 

p.  E. 

No.  of  Cases 

1st  Interval 

2d  Interval 

No.  of  Cases 

Med. 

P.  E. 

No.  of  Cases 

3.0'  + 

Total 

Med. 

P.  E. 

Med. 

P.  E. 

1st  Int. 
3-0  •  + 

2d    Int. 
i.o'  + 

Total 

3.0'  + 

Total 

I 

■9 

.00 

6 

•9 

•05 

1-3 

•15 

6 

8 

II 

I.O 

■05 

6 

I.O 

•15 

13 

•55 

4 

7 

III 
IV 

•9 
■9 

.8-1.2 

3 
I 

[..„ 

1. 0-1.2 

1-3 

1.2-4.2 

3 

3 

V 

1.2 

I.0-I.2 

3 

I.O 

.00 

1-3 

.10 

4 

4 

1.2 

I 

VI 

I.I 

.9-1.2 

3 

•9 

.9-1.0 

1.4 

1. 4-1. 5 

2 

2 

I.I 

.10 

4 

VII 

•9 

.9-1.0 

2 

1.6 

1. 2-1. 9 

.6 

.6-1.6 

I 

3 

VIII 

■9 

■9--9 

2 

1.2 

I.I-I.3 

.8 

■  7-9 

2 

1.2 

I 

Totals 

26 

20 

29 

6 

Separate  Hot 

Response  H-C 

Response  Hot 

I 

I.O 

.10 

6 

II 

I.I 

•05 

6 

III 

I.O 

.8-1.4 

3 

1.2 

2.8 

I 

I 

IV 

1.6 

I 

V 

I.I 

1.0-1.6 

3 

VI 

1.4 

.9-1 .6 

3 

VII 

I.O 

I.O-I.O 

2 

2.1 

3-2 

I 

I 

VIII 

I.O 

I.O-I.O 

2 

Totals 

26 

2 

2 

*  Total  range  given  with  less  than  four  cases. 


t  Patient  came  only  once. 


Temperature  Sensitivity 


357 


TABLE  4 

MEDI.\N  RE.\CTION-TIME  FOR  SEPARATE  AND  DOUBLE  STIMULI  IN  PERIPHER.VL  NEURITIS 

Case  XVIII— L.  R. 


.                 „..„.       .. 

Double  Stimuli 

Response  C-H 

Response  Cold 

Med. 

P.  E. 

No.  of  Cases 

1st  I 

iterval 

2d  Inter\'al 

No.  of  Cases 

Med. 

p.  E. 

No.  of  Cases 

3.0'  + 

Total 

Med. 

P.  E. 

Med. 

P.  E. 

1st 
3- 

Int. 

0'  + 

2d    Int. 

Total 

3.0'  + 

Total 

I 

1.2 

•05 

11 

1-4 

•25 

■5 

.10 

2 

27 

II 

1.2 

.20 

11 

1.2 

•05 

■4 

.00 

24 

III 

I.I 

I 

1-4 

•05 

■4 

•15 

1 

5 

Totals 

23 

3 

56 

Separate  Hot 

Response  H-C 

Response  Hot 

I 

1.2 

•05 

13 

1.8 

.40 

.6 

.80 

2 

6 

I.I 

I 

II 

1.2 

■15 

9 

1.8 

.40 

.8 

.00 

I 

4 

2.6 

I 

III 

2.2 

I 

Totals 

23 

3 

10 

2 

Case  XIX— M.  F.f 

Separate  Cold  Stimuli 

Double  Stimuli 

Response  C-H 

Response  Cold 

Med. 

p.  E. 

No.  of  Cases 

1st  Inter\'al 

2d  Interval 

No.  of  Cases 

Med. 

p.  E. 

No.  of  Cases 

3.0'  + 

Total 

Med. 

p.  E. 

Med. 

p.  E. 

1st  Int. 
3.0 '-I- 

2d    Int. 

I.0'  + 

Total 

3-0'  + 

Total 

I 

II 

1.6 

1.2 

1.2-2.0* 
1.2-2.0 

2 

3 

1.4 

1^5 

•15 

■5 

•4 

•05 

I 

5 

I 

4-5 

2.9-6.2 

I 

2 

Totals 

5 

I 

6 

I 

2 

Separate  Hot 

Response  H-C 

Response  Hot 

I 
II 

1-3 
1^3 

I -3-1 -4 
1. 2-1. 4 

2 

2 

1-4 
2.0 

1. 3-1. 6 
■25 

.6 

I.O 

■5--7 
•.10 

6 

2 
II 

1-7 

1 .6-4.0 

I 

3 

Totals 

4 

1 

6 

13 

I 

3 

CaseXX— H.  T.t 


Double  SUmuli 

Response  C- 

H 

Response  Cold 

No.  of  Cases 

1st  Interval 

2d  Interval 

No.  of  Cases 

No.  of  Cases 

Med. 

p.  E. 

3-0'  + 

Total 

Med. 

p.  E. 

Med. 

P.  E. 

1st  Int. 
3.0'-f 

2d    Int. 

I.0'  + 

Total 

3.0'  + 

Total 

I 

I.I 

.00 

5 

1.0 

•15 

.6 

■05 

I 

4 

11 

I.I 

.00 

4 

1.0 

■05 

.8 

■05 

I 

4 

111 

I.I 

.9-1.2 

3 

[I.I 

.10 

.8 

•05 

4 

IV 

(No 

stimuli) 

1 

V 

I.I 

I 

I.I 

•05 

.8 

.10 

I 

4 

VI 

(No 

stimuli) 

1.2 

•05 

.8 

.00 

I 

4 

Totals 

13 

4 

20 

Separate  Hot 

Response  H- 

: 

Response  Hot 

I 

.8 

.10 

5 

1.2 

■15 

I.O 

■30 

7 

12 

11 

■9 

.00 

5 

I.I 

•05 

.8 

•25 

5 

12 

III 

.8 

.8-1.0 

3 

I1.2 

.20 

1.0 

.30 

5 

7 

IV 

(No 

stimuli) 

1 

V 

(No 

stimuli) 

1.4 

•05 

1.0 

.10 

I 

I 

VI 

1.0 

I.O-I.I 

2 

Totals 

15 

18 

32 

■  Totals  given  with  less  than  four  cases. 


t  Patient  came  only  once. 


358 


Temperature  Sensitivity 

TABLE  4.  (Peripheral  Neuritis  concluded) 

Case  XXI— B.  P.f 


Double  Stimuli 

Separate  ^om  st.mu,, 

Response  C-H 

Response  Cold 

Med. 

P.  E. 

No.  of  Cases 

ist  Interval 

2d  Interval 

No.  of  Cases 

Med. 

P.  E. 

No.  of  Cases 

30'  + 

Total 

Med. 

P.  E. 

Med. 

P.  E. 

1st  Int. 

3.0'  + 

jd    Int. 

i,o-  + 

Total 

3-0'  + 

Total 

I 

II 

III 

1.8 
1-7 
1.6 

.10 

•30 

1.6-2.0 

5 
5 
3 

2.7 
2.4 

2.8 

•30 

•55 

■4 
•5 
.6 

•05 
•15 

4 
5 

I 

8 
12 

I 

2.6 

1.8 

.10 

I 

4 

Totals 

13 

9 

I 

21 

5 

Separate  Hot 

Response  H-C 

Response  Hot 

I 

II 
III 

1-9 
1.6 
2.1 

.10 

•15 

1.5-2.6 

5 
5 
3 

2.3 

I.I 

I 

I 

30 

.20 

3 

5 

Totals 

13 

I 

I 

3 

5 

t  Patient  came  only  once. 

TABLE  5 

MEDIAN  REACTION-TIME  FOR  SEPARATE  AND  DOUBLE  STIMLXI  IN  A  CASE  OF  THALAMIC  LESION 

Case  XXII— D.  L. 


Double  Stimu 

i 

Response  C-H 

Response  Cold 

Med. 

P.  E. 

No.  of  Cases 

1st  Interval 

2d  Interval 

No.  of  Cases 

Med. 

p.  E. 

No.  of  Cases 

3-0'  + 

Total 

Med. 

P.  E. 

Med. 

P.  E. 

1st  Int. 
3.0'  + 

2d    Int. 
1.0'  + 

Total 

3-0'  + 

Total 

I 

2.2 

•25 

12 

2.2 

•35 

4 

30 

II 

2.0 

.40 

II 

2.6 

•55 

I.I 

•35 

4 

14 

17 

III 

IV 

2.3 

2.4 

•55 
2.3-2.6 

I 

6 

2 

}- 

.40 

1.2 

.20 

2 

3 

4 

2-4 

.00 

I 

4 

V 

2.4 

•45 

I 

7 

26 

■35 

6 

24 

VI 

2.6 

.40 

2 

5 

2.6 

•65 

I.I 

•30 

5 

14 

15 

2.8 

•15 

2 

4 

VII 

2.3 

.10 

4 

2.2 

1.8-2.9 

I.O 

.9-1.2 

2 

3 

2.6 

•25 

5 

VIU 

2-5 

•50 

2 

4 

2.5 

1.9-3.0 

1.2 

1. 0-2. 1 

I 

3 

3 

2.8 

.70 

4 

II 

Totals 

6 

51 

12 

36 

42 

17 

78 

Separate  Hot 

Response  H-C 

Respon 

se  Hot 

I* 
II 

1-7 

.10 

I 

12 

2.0 

•15 

.8 

•15 

2 

9 

2.0 

•35 

5 

III 

IV 

2.6 
2.0 

•25 
2.0-2.0 

I 

5 
2 

}- 

•15 

I.I 

■50 

2 

4 

2.7 

•15 

4 

V* 

VI 

2.9 

•15 

2 

4 

2.2 

■30 

.6 

.10 

I 

2 

8 

VII* 

2-7 

I 

2.0 

.20 

.6 

•30 

2 

7 

2.2 

I 

VIII 

*i.7 

I 

3-2 

3 -0-3 -5 

.6 

.6-.  7 

2 

2 

1-5 

I 

Totals 

4 

25 

1     3 

8 

30 

II 

*  In  response  to  hot  stimulus: 
Region    I  gave  10  responses  Co/J-Med.  2.8;   P.  E.  .40.      Region    VII  gave    2  responses  Cold-Med.  2.7: 
Region    V  gave    6  responses  Cold-Med.  3.6;   P.  E.  .95.    Region  VIII  gave    i  response    Cold-Med.  3.8. 


range  2.7-3.2. 


Temperature  Sensitivity 


359 


TABLE  6 

PERVERSION  OF  RESPONSE — PERCENTAGE  OF  STIMULI  GIVING  OPPOSITE  RESPONSE 


Syringomyelia 

Tabes  Dorsalis 

P.  K. 

E.  \Vi. 

A.C. 

L.  A. 

J.  CI. 

B.  T. 

G.  C. 

P.O. 

J.  Co. 

L.  F. 

H.  D. 

C 

H 

c 

H 

C 

H 

C 

H 

C 

H 

C 

H 

C 

H 

C 

H 

C 

H 

C 

H 

C 

H 

Hand,  R 
L 
Forearm,  R 
L 
Arm,  R 
L 
Face,  R 
L 
Neck" 
Leg,  R 
L 
Thigh,  R 
L 
Foot,  R 
L 
Abdomen,  R 
1                   L 
Back,  R 
L 

lOO 

40 

40 
40 

35 
50 

50 
50 

100 

100 
100 
50 
67 

{3, 

50 
1  33 

50 

50 

1  33 

67* 

50* 
50* 

50* 

Us* 

1  80* 

[  Right 
•   arm 
[  100 

100 
100 

{'^ 

50 
50 

33 
33 

17 

17 
20 
17 
17 

r 

50 
67 
100 
67 
33 
33 

{67 

Multiple  Sclerosis 

Neuritis 

Thai.  Les. 

E.  Wa. 

J.Q. 

G.  p. 

J.T. 

I.  R. 

J.  B. 

L.  R. 

M.  F. 

H.  T. 

B.  P. 

D.  L. 

C 

H 

C 

H 

C 

H 

C 

H 

C 

H 

C 

H 

C 

H 

C 

H 

C 

H 

C 

H 

C 

H 

Hand,  R 
L 
Forearm,  R 
L 
Arm,  R 
L 
Face,  R 
L 
Neck 
Leg,  R 
L 
Thigh,  R 
L 
Foot,  R 
L 
Abdomen,  R 
L 
Back,  R 
L 

33 

33 

100 
100 

50 

100 
100 
100 
100 

50 
50 

'■  Includes  some  cases  in  which  a  very  dubious  correction  was  made,  from  .8  to  5.0  seconds  later. 


36o 


Hand,  R 
L 
Forearm,  R 
L 
Arm,  R 
L 

1^ 
Face,  ^  M 

[l 

Xeck 
Leg,  R 
L 
Thigh,  R 
L 
Foot,  R 
L 
Abdomen,  R 
M 
L 
Back,  R 
M 
L 


Hand,  R 
L 
Forearm,  R 
L 
Arm,  R 

L 
Face,  R 

L 
Xeck 
Leg,  R 
L 
Thigh,  R 
L 
Foot,  R 

L 
Abdomen 
Back 

R 

-M 

L 


Temperature  Sensitivity 


TABLE  7 

FAU-CRE  TO  REACT— PERCENTAGE  OF  STIMtT-I  GIVING  NO  RESPONSE 


S.\Tingoinyeiia 


P.  K. 


A.  C. 


J.  CI. 


25 


80 
67 
100 
67 
40 


100 
100 


75 


Right  arm — 
C  &  H-17% 

Left    arm — 
C&H— 67% 


38 
63 


Multiple  Sclerosis 


C  indicates  cold  stimuli;  H,  hot;  and  D,  double  stimuli. 

♦Areas  usually  stimulated  gave  no  response;  responses  were  obtained  on  shoulder  blades. 


Temperature  Sensitivity 
TABLE  7.  (concluded) 

361 

■■                 

Tabes  Dorsalis 

G.  C.                     1 

P.O.                   1 

J.  Co.                      1 

L.  F.                     1 

H.D. 

C 

H 

D 

C 

H 

D 

c 

H 

D 

C 

H 

D 

C 

H 

D 

67 

25 

Neuritis 

Thalamic  Lesion 

L.  R. 

M.  F. 

H.T.                     1                      B.P.                     1 

D.  L. 

C 

H 

D 

C 

H 

D 

C 

H 

D 

C 

H 

D 

C 

H 

D 

1 

33 

33 

i4t 

50 
50 

25 

hese  p 
face  o 

:rc£ 
f  th 

ntage 
eleft 

3  w 
har 

ere  wit 
id. 

1  temp 

era 

tures 

of  I 

6-1 7» 

md  46-51 

)»C.;  ten 

iperatur 

es  of  i8» 

and  40° 

evoked 

no  respo 

nse  on  t 

le  median 

362 

Temperature  Sensitivity 

, 

■ 

TABLE  9 

DIMINUTION  OF  SENSATION— PER  CENT.  OF 

WARM  RESPONSES 

Syringomyelia 

Tabes  Dorsalis 

p 

K. 

E. 

Wi. 

A.C. 

L.  A. 

J.  CI. 

B.  T. 

G.C. 

P.O. 

J.  Co. 

L.  F. 

H.  D.J 

Region 

D 

S 

D 

s 

D 

S 

D 

s 

D 

s 

D 

S 

D 

s 

D 

S 

D 

s 

D 

S 

D 

I 

97 

64 

94 

58 

67 

50 

100 

100 

100 

100 

38 

31 

32 

17 

71 

II 

76 

92 

70 

28 

100 

67 

100 

100 

100 

100 

12 

23 

50 

47 

18 

III 

67 

-I 

91 

50 

40 

33 

100 

100 

ICO 

100 

20 

25 

IV 

100 

100 

50 

50 

100 

100 

100 

100 

75 

50 

V 

83 

67 

81 

83 

8 

100 

100 

100 

100 

18 

44 

75 

86 

60 

VI 

94 

83 

100 

50 

33 

100 

100 

100 

100 

38 

33 

57 

71 

60 

VII 

38 

50 

88 

100 

60 

25 

TOO 

100 

100 

100 

33 

VIII 

100 

75 

53 

50 

25 

100 

100 

100 

100 

27 

29 

DIMINUTION  OF  SENS.\TION — PER  CENT.  OF  COOL  RESPONSES 


Syringomyelia 

Tabes  Dorsalis                                        1 

p.  K. 

E.  Wi. 

A.C. 

L.A. 

J.  CI. 

B.  T. 

G.C. 

P.O. 

J.  Co. 

L.  F. 

H.  D.; 

D 

s 

D 

S 

D 

S 

D 

S 

D 

S 

D 

S 

D 

S 

D 

S 

D 

S 

D 

S 

D 

I 

II 

III 

IV 

V 

VI 

VII 
VIII 

7 
10 

^■^ 

50 

25 
14 
16 
50 
50 
27 
14 

14 

13 

TABLE  10 

INTENSIFICATION  OF  SENSATION 


Sj-ringomyelia 

Tabes  Dorsalis 

P.  K. 

E.  Wi. 

A.C. 

L.A. 

J.  CI. 

B.T. 

G.C. 

P.O. 

J.  Co. 

L.  F. 

H.  D. 

D 

S 

D 

S 

D 

S 

D 

S 

D 

S 

D 

S 

D 

S 

D 

s 

D 

S 

D 

s 

D       S 

I 
II 

iC* 

III 

iHC 

IV 

V 

IH 

iC 

iCH 

2C 

iC 

iC» 

VI 

2M 

iC 

iHC 
iC 

iHC 

iC 

VII 

iHC 
iH 

2CH 
iHC 

3C 

4HC 
4H 

6Ct 
5Ht 

iCH  '2< 
iC     2I 

2H 

VIII 

2H 

iC 

iC* 

3H 

2H 

iC 

iC 
iH 

4HC 
5H 

6C11 
5Ht 

iH 

Under  D  is  shown  the  number  of  cases  of  reflex  retraction  from  a  double  stimulus,  with  initials  indicating  the  type  C 
response;   under  S  reflexes  occurring  with  single  stimuli — initials  indicating  which. 


[table  8  WILL  BE  FOUND  ON  PAGE  364J 


Temperature  Sensitivity 


363 


Multiple  Sclerosis 


Thalamic 
Lesion 


1 30 

in 


1 

Multiple 

Sclerosis 

Ne 

uritis 

Thalamic 
Lesion 

E.  \Va. 

J.Q. 

G.  P. 

J.T. 

I.  R. 

J.  B. 

L.  R. 

M.  F. 

H.  T. 

B.  P. 

D.  L. 

D 

S 

D 

S 

D 

S 

D 

s 

D 

s 

D 

s 

D 

S 

D 

S 

D 

S 

D 

S 

D 

s 

7 

6 

7 
8 

7 

II 

33 

14 
60 

Under  D  is  to  be  found  the  per  cent,  of  responses  to  double  stimuli  including  any  perception  of  the  hot  stimulus,  which 
were  warm;   under  S  the  per  cent,  of  warm  responses  to  single  hot  stimuli. 

Multiple  Sclerosis 

Neuritis 

Thalamic  Lesion 

E.  \Va. 

J.Q. 

G.  P. 

J.T. 

I.  R. 

J.  B. 

L.  R. 

M.  F. 

H.  T. 

B.  P. 

D.  L. 

D 

S 

D 

S 

D 

S 

D 

s 

D 

s 

D 

s 

D 

S 

D 

S 

D 

S 

D 

S 

D 

S 

4C 

iC 

iH 

iC 

ICH 

2C 

iC 

4CH 

iC 
iC 

IC 
6C 

IC 

2C 

iCc^lH 

IC 

iC&iH 

*l 

1l3 

lespoi 
resp 

ise  W8 
jnses 

sH-( 
vvere 

;orP 
■i-C, 

H. 

t3 

t2 

respoi 
respoi 

ises  w 
ises  w 

ereH 
ereH 

-c. 

-C. 

364 


Temperature  Sensitivity 
TABLE  8 

CONSISTENCY  OF  RESPONSE 


Neuritis 

Syringomyelia 

Tabes  Dorsalis 

Multiple 

Sclerosis 

Thalamic 

Single  Stimuli 

Lesion 

P.  K. 

E.Wi. 

J.  Cl. 

G.  C. 

P.O. 

J.  Co. 

L.    F. 

H.  D. 

E.Wa 

J.   Q. 

G.  P. 

J.    T. 

L.   R. 

D.  L. 

Per  cent,  of  areas  having 

Cold — 2  C  responses 

56 

92 

44 

73 

96 

96 

46 

100 

100 

100 

89 

100 

90 

92 

Hot — 2  H  responses 

S4 

73 

100 

50 

92 

96 

69 

100 

100 

100 

96 

IOC 

100 

44 

Cold — range  i.o' 

14 

17 

16 

24 

17 

23 

23 

8 

23 

20 

Hot — range  I.o' 

10 

II 

6 

10 

4 

8 

28 

20 

12 

4 

19 

27 

Cold — range  <.3" 

20 

47 

19 

32 

60 

33 

35 

65 

77 

50 

12 

56 

24 

Hot — range  <.3" 

33 

50 

69 

35 

64 

52 

28 

24 

42 

73 

52 

69 

75 

36 

Double  Stimuli 

Per  cent,  of  areas  having 

2  or  more  responses — C-H 

40 

48 

J7 

28 

38 

45 

8 

3 

20 

48 

75 

43 

89 

35 

2  or  more  responses — H-C 

8 

18 

33 

20 

5 

70 

25 

ID 

13 

16 

20 

2  or  more  responses — C 

18 

13 

8 

18 

33 

28 

15 

65 

15 

48 

23 

6 

48 

2  or  more  responses — H 

25 

3 

96 

25 

23 

35 

8 

20 

45 

23 

75 

5 

C-H,  1st — range  1.0' 

19 

35 

0 

27 

54 

6 

33 

100 

0 

0 

23 

29 

25 

50 

2nd — range  1.0' 

25 

21 

25 

27 

33 

28 

0 

100 

63 

42 

40 

24 

0 

35 

C-H,  1st — range  <  .3" 

25 

24 

100 

91 

7 

67 

33 

0 

50 

58 

23 

47 

25 

0 

2nd — range  <  .3" 

38 

35 

50 

27 

27 

39 

67 

0 

13 

16 

30 

53 

70 

21 

H-C,  1st — range  1.0" 

33 

29 

65 

38 

0 

25 

10 

0 

40 

0 

13 

2nd — range  1.0" 

67 

29 

38 

50 

50 

18 

90 

75 

60 

67 

38 

H-C,  1st — range  <  .3" 

0 

43 

8 

38 

50 

22 

40 

0 

40 

33 

38 

2nd — range  <  .3" 

33 

43 

23 

50 

50 

68 

0 

0 

0 

33 

0 

C — range  1.0" 

28 

60 

0 

57 

46 

0 

0 

54 

33 

0 

44 

50 

63 

C — range  <  .3" 

29 

0 

0 

14 

15 

46 

17 

8 

17 

68 

II 

0 

0 

H — range  1.0" 

40 

0 

0 

40 

44 

21 

0 

50 

28 

13 

7 

100 

H — range  <  .3" 

10 

100 

22 

50 

22 

29 

50 

13 

39 

50 

43 

0 

The  percentage  of  areas  having  two  responses  of  a  kind  is  calculated  on  the  basis  of  all  areas  stimulated — forty 
for  double  stimuli,  twenty-si,\  for  single  stimuli  (except  in  cases  where  for  some  reason  an  area  failed  to  receive 
two  stimulations).* 

The  percentage  of  areas  having  a  given  range  is  calculated  on  the  basis  of  the  number  of  areas  giving  two  responses 
of  the  sort  indicated. 

Figures  in  italics  indicate  percentages  outside  of  normal  limits — i.  e.,  deviating  from  the  normal  average  by  more 
than  two  and  a  half  times  the  average  deviation.  But  C  or  H  responses  among  normals  were  so  infrequent  that 
the  time-fluctuation  was  not  calculated. 

*  For  single  stimuli,  two  responses  of  a  kind  indicates  100  per  cent,  for  that  area,  in  general;  for  double  stimuli.  50  per 
cent. 


[owing  to  exigencies  of  M.\KE-UP,  T.\BLES  9  .\ND  10  WILL  BE  FOUND  ON  P.\GES  362  .\ND  363] 


Temperature  Sensitivity 


365 


TABLE  II 

COMPARISON  OF  THE  REACTION-TIME  OF  COLD  AND  HOT  IN  SINGLE  STIMULI 


Multiple  Sclerosis 


P.  K. 
E.  Wi. 

A.  C. 
L.  A. 
J.  CI. 

B.  T. 
Average 


■  of  C  >  H 


No.  of 
Regions 


Average 

Amount 

Sec. 


■50 
•13 

1.05 
.48 
.24 

1.90 
.48 


Time  of  H  >  C 


No.  of 
Regions 


Average 

Amount 

Sec. 


.23 

•44 
1. 00 
.40 

.ID 


Time  of 
C  =  H 


No.  of 
Regions 


E.  Wa. 
J.Q. 
G.  P. 
J.T. 
I.  R. 
J.  B. 
Average 


Time  of  C  >  H 


No.  of 
Regions 


Average 
Amount 


.28 
■05 
.10 
•17 


Time  of  H  >  C 


No.  of 
Regions 


Average 
Amount 


No.  of 
Regions 


Tabes  Dorsalis 


G.  C. 
P.O. 
J.  Co. 
L.  F. 
H.  D. 
Average 


6 

4 

3 

5 

3-6 


2 

•45 

I 

.10 

6 

•32 

5 

•30 

2 

.80 

3-2 

•39 

L.  R. 

M.  F. 

I 

H.  T. 

4 

B.  P. 

I 

Average 

1-5 

.30 

•37 


Thalamic  Lesion 


TABLE  12 

COMPARISON  OF  THE  REACTION-TIME  OF  COLD  AND  OF  HOT  RESPECTIVELY  IN  SINGLE  AND  DOUBLE  STIMULI 


C  &  C-H 

H  &  H-C 

C  &  C-H 

H  &  H-C 

C  &  C-H 

H  &  H-C 

C  &  C-H 

H  &  H-C 

P.  K. 

+   .1 

+2.1 

G.  C. 

+6.3 

+7^4 

E.  Wa. 

+  1^7 

+  1.0 

L.  R. 

+    •S 

+  1.2 

E.  Wi. 

+   .8 

+  1^4 

P.O. 

+2.6 

+4^8 

.T.Q. 

-  ^4 

M.  F. 

+   .1 

+   .8 

A.C. 

!•  Co. 

+  1.6 

+  .6 

G.  P. 

+  ■•3 

+3^1 

H.T. 

—    .2 

+  1.0 

L.A. 

-1.8 

+    •! 

L.  F. 

+   -1 

-1.8 

J^T. 

0 

+4^3 

B.  P. 

+  2.8 

.!•  CI. 

—   .2 

H.D. 

+  ^4* 

+2.7 

LR. 

+  r9 

+  ^8 

B.T. 

-  •S* 

+  -9* 

J.B. 

+  -1 

D.L. 

+  .8 

+  .4 

Av. 

-  •S 

+  1.1 

+2.3 

+2.7 

+  -9 

+2.3 

(Neur.) 

+  .8 

+  i^3 

These  figures  represent  the  sum  of  the  gains  in  time  of  medians  (in  seconds)  for  each  individual  in  double  stimuli 
over  medians  in  single  for  same  region.  Starred  figures,  however,  are  gains  of  averages,  so  calculated  because  of 
too  few  cases  to  calculate  by  regions. 


366 


Temperature  Sensitivity 
CHART  A 

SLMMARY  OF  DISTURB.\XCE  IN  ALL  CASES 


Syringomyelia 

Tabes  Dorsalis 

P.  K. 

E.  Wi. 

A.  C. 

L.  A. 

J.  CI. 

B.  T. 

G.  C. 

P.O. 

J.  Co. 

L.  F. 

H.  D. 

Failure  to  react 

+ 

+  +  + 

+ 

++++ 

+  + 

+ 

Perversion 

+  + 

+ 

+  +  + 

+  + 

+++ 

+  +  +  + 

+  +  + 

+ 

+  + 

+  +  + 

Type  of  response 

+  + 

+ 

+  +  +  + 

+  +  + 

++++ 

+  + 

+  +  +  + 

+  +  +  + 

+  + 

+  + 

+  +  +  + 

Median  reaction-time 

+  +  + 

+  + 

+  +  +  + 

+  + 

+ 

+  + 

+  + 

+ 

+ 

+ 

+  +  + 

Extreme  reactions 

+  +  + 

+  +  + 

+  +  +  + 

+  +  + 

++ 

+  + 

+  +  +  + 

++  + 

+ 

+ 

+  +  +  + 

Consistency 

+  +  +  + 

+  +  + 

No  meas. 

No  meas. 

++ 

No  meas. 

+  +  +  + 

+  +  + 

+  + 

+  +  + 

+  +  + 

Diminution  of  sensation 

+  +  +  + 

+  +  +  + 

+  + 

+  +  +  + 

+  +  +  + 

+  +  + 

+  + 

+  + 

Intensification 

+ 

+ 

+ 

+  + 

+ 

+ 

+  + 

Relatively  greater  dis- 

turbance 

CsHd 

H 

C 

C 

C 

C 

C 

C,Hd 

H 

c 

C.Hd 

Degree  of  disturbance 

+  + 

+  + 

+  +  +  + 

+  + 

++++ 

+  +  + 

+++ 

+  + 

+ 

+ 

+  +  + 

Disturbance  general 

+ 

+ 

+ 

+ 

+ 

+ 

+ 

+ 

Disturbance  local 

+ 

+ 

+ 

Multiple  Sclerosis 

Neuritis 

Thalamic 
Lesion 

E.  Wa. 

J.Q. 

G.  P. 

J.T. 

I.  R. 

J.  B. 

L.  R. 

M.  F. 

H.  T. 

B.  P. 

D.L. 

Failure  to  react 

+ 

+ 

+ 

Perversion 

+ 

+  +  +  + 

Type  of  response 

+  +  +  + 

+  +  +  + 

+ 

+  +  + 

+ 

+ 

+ 

+ 

+ 

+  + 

Median  reaction-time 

+ 

+ 

+ 

+ 

+ 

+ 

+  + 

+ 

+  + 

+  + 

Extreme  reactions 

+  + 

+  + 

+ 

+  + 

+ 

+  + 

-I-+  + 

+  + 

+  +  + 

+  +  +  + 

Consistency 

+  +  + 

+  + 

+ 

+  + 

No 
meas. 

No  meas. 

+ 

No 

meas. 

No 
meas. 

No  meas. 

+  +  +  + 

Diminution  of  sensation 

+  + 

+  +  +  + 

+  +  +  + 

+ 

+  +  +  + 

+  +  +  + 

+ 

+ 

+  +  +  + 

Intensification 

+ 

+ 

+ 

+ 

+ 

+  + 

Relatively  greater  dis- 

turbance 

C  =  H 

H 

H 

C 

C  =  H 

H 

— 

C 

C? 

? 

H 

Degree  of  disturbance 

+ 

+ 

+ 

++ 

+ 

+ 

- 

+  +  + 

? 

? 

+  +  +  + 

Disturbance  general 

+ 

+ 

+ 

+ 

? 

? 

Disturbance  local 

+ 

+ 

+ 

+ 

In  each  aspect  of  the  experiment,  as  designated  on  the  left,  the  relative  degree  of  disturbance  is  indicated  for  each  subject 
by  the  number  of  plus  signs— except  in  the  last  two,  where  the  sign  signifies  whether  the  disturbance  was  general  or  local 
in  character. 


Temperature  Scnsiti\ity 


367 


That  there  is  in  most  of  these  cases  a  de- 
parture from  the  normal  reaction  is  evident; 
and  that  the  double  stimulation  shows  a  dis- 
turbance not  always  evident  with  separate 
stimuli  is  also  clear.  Perhaps  the  nature  of 
the  disturbance  will  be  more  quickly  grasped 
by  the  summary  in  Chart  A,  in  which  the 
estimated  degree  of  disturbance  shown  by 
each  subject  in  the  various  aspects  of  the 
test  is  indicated  by  plus  signs. 

The  chart  is  also  a  convenient  reference 
table  for  comparing  the  various  syndromes. 
There  are  a  few  salient  points  to  be  noted : 

1.  Failures  are  by  far  the  most  frequent  in 
syringomyelia. 

2.  Perversions  are  commonest  in  syringomyelia; 
but  are  frequent  also  in  tabes,,  and  in  the  case  of 
thalamic  lesion. 

3.  In  type  of  response  neuritis  deviates  least 
from  normal — but  these  cases  for  the  most  part 
showed  no  clear-cut  disturbance.  Other  syndromes 
do  not  differ  significantly  in  this  respect  one  from 
another. 

4.  In  reaction- time  multiple  sclerosis  is  nearest  to 
normal.  If  reference  is  made  to  Tables  1-5  it  will  be 
seen  that  these  cases  are  generally  prompt  in  reaction 
to  separate  stimuli;  and  that  they  generally  show  a 
retardation,  chiefly  in  the  second  interval  of  double 
responses. 

5.  Extreme  reactions  in  the  second  interval  of 
double  responses  only  are  characteristic  of  multiple 
sclerosis.  Except  in  multiple  sclerosis  extreme  reac- 
tions are  also  frequent  in  siitgle  responses  to  double 
stimuli. 

6.  Diminution  of  intensity  of  sensation  is  least 
and  intensification  is  most  in  tabes  dorsalis. 

7.  Cold  is  more  likely  to  show  a  greater  distur- 
bance than  hot  in  syringomyelia;  hot  more  than  cold 
in  multiple  sclerosis. 

8.  All  factors  considered,  multiple  sclerosis  shows 
the  least  degree  of  disturbance. 

9.  The  disturbance  is  unlikely  to  be  local  in  tabes, 
most  likely  to  be  local  in  syringomyelia. 

Summarizing,  one  may  say  that  under  the 
conditions  of  the  experiment — for  these  sub- 
jects at  least — frequency  of  failures  and  of 
perversions,  generally  lengthened  reaction- 
times,  diminution  of  sensation,  and  tenden- 
cies toward  marked  local  disturbance  are 
indicative  of  syringomyelia.  Perversions 
without  failures;  somewhat  lengthened  re- 
action-time— especially  in  double  stimuli; 
tendencies  toward   intensification;    and   gen- 


eral, rather  than  local,  character  of  distur- 
bance suggest  tabes.  A  generally  normal 
or  nearly  normal  reaction — except  for  a 
lengthened  interval  between  the  perception 
of  the  two  stimuli — is  characteristic  of  multi- 
ple sclerosis.  The  lesion  of  the  brain  stem  is 
distinguished  from  those  of  the  cord  by  the 
unilateral  character  of  the  disturbance,  and 
by  the  clear-cut  selection  of  one  sort  of  sensa- 
tion as  evidenced  by  the  responses.  Peri- 
pheral disturbances,  such  as  traumatic  neu- 
ritis, are  not  adequately  shown  by  this  method 
of  testing. 

There  are  a  few  points  which  may  be  of 
general  interest  to  the  theory  of  temperature 
sensations.  One  is  the  relation  of  the  order 
of  response  in  double  stimuli  to  the  length 
of  reaction  of  cold  and  hot  separately. 
It  will  be  remembered  that  with  normals, 
while  the  time  for  cold  and  hot  was  about  the 
same,  the  majority  of  responses  to  the  double 
stimulus  were  in  the  order  cold-hot  and  that 
these  responses  were  slightly  more  prompt 
and  less  variable,  in  both  intervals,  than 
those  in  the  order  hot-cold;  '  that  the  responses 
of  hot  followed  quite  regularly  upon  those  of 
cold  except  on  legs  and  feet,  where  it  was 
somewhat  delayed.  In  testing  abnormals  we 
have  an  opportunity  to  see  what  happens 
when  the  times  of  hot  and  cold  are  more 
variable. 

Table  11  gives  a  summary  of  the  relation 
of  cold  and  hot  on  each  region,  for  the  various 
subjects.  We  find,  that  in  spite  of  greater 
variability  there  is,  generally  considered,  the 
same  overlapping  in  the  times  of  cold  and  hot 
that  was  found  among  normals.  There  are 
four  subjects,  however,  in  whom  is  shown  a 
fairly  distinct  tendency  of  hot  to  be  slower — 
E.  Wi.,  J.  Co.,  J.  Q.  and  J.  B.;  and  there  are 
six  who  show  a  somewhat  slower  time  for 
cold— P.  K.,  J.  CI.,  G.  C,  P.  O.,  H.  D.  and 
J.  T.  Of  the  cases  in  whom  cold  is  quicker, 
we  find,  by  comparing  the  frequency  of  dif- 
ferent types  of  response  to  double  stimuli 
(Tables  1-5),  that  C-H  responses  exceed 
H-C  in  all  cases,  and  C  exceed  H  in  all  but 
one  case;  that  C-H  is  the  most  frequent  type 
in  all  but  one  case,  in  whom  C  has  the  highest 
frequency.     On  the  other  hand,  among  those 

'Neurological  BuUetinrloc.  cit..  Table  12,  p.  156 


Temperature  Sensitivity 


100 

95 

90 

85 

90 

A 

•rs 

/ 

\ 

70 

/ 

\ 

65 

/ 

\ 

60 

A              / 

\ 

SS 

A    / 

\              / 

p50 

/\    / 

\          / 

t4.5 

/  \  / 

\     / 

f40 

/  V 

Y 

30 

^J 

A 

/\ 

25 

\  ''  I 

\  /.-  y- 

/      \ 

20 
IS 

10 

05 

//  •  ••■•    '-^ 

0 

s 

I       D       m      W      Y      VI      VD 


P.K. 


E.W.. 


100 

35 

90 

85 

80 

15 
10 
65 
bO 
SS 

/, 
/ 
/     \ 

i    \ 

50 

■■■■.'      1 

K 

/  ■. 

i 

S5 

/     ■• 

X    ■■/    •. 

/ 

30 
25 
20 
15 

/        '.  . 

'tM 

/ 

10 

•^\           / 

1  ,'\    1 

5 

\       / 

■  --.J 

!• 

^  -  '      *  -  \            /' 

n     m     K    Y    VI    m 


Temperature  Sensitivity 


inmiTvviwM 


LA. 


inrawYvivnviii  iiiinivvviwivni 


1     n     in     w     u     B    m 


H.D. 


Fig.  I.  (Top)  Distribution  of  Types  of  Response 
IN  Syringomyelia 


C-H    -.-H-C    -- 


.  Duobtful 


Fig.   2.     (Centre)    Distribution  of    Types   of 
Response  in  Tabes  Dorsalis 


C-H 


H-C 


.  Doubtful 


Fig.   3.     (Lower)    Distribution   of    Types   of 
Response  in  Multiple  Sclerosis 


■C-H 


■H-C    -- 


.  Doubtful 


inmffvnvnair 
J.T. 


I       D       IDK7Y1TOVID 


I.R. 
369 


I       n       ffl      H      V      H      Vff     BB 


Temperature  Sensitivity 


fe 


■  •  •  > 


IT       HI 


1     n     m    cr    Y    Yi 


H.T. 


4.     Distribution  of  Types  of  Response  in  Peripheral  Neuritis  Fig.  5.     Distribution  of  Types 

—  C-H    -.- H-C     C     ....  H      Doubtful  of   Response  in  a  Capsulothalamic 

Lesion 


fu.  r^u.     JsH     •";; 


Fig.  6.     Extreme  Reactions 
A  graph  showing  manner  in  which  extreme  reactions  were  distributed  among  the  different  types  of  response 


who  show  a  slightly  slower  reaction  to  cold, 
H-C  responses  exceed  C-H  in  only  one  case, 
though  H  are  more  frequent  than  C  in  four 
cases;  and  the  most  frequent  type  in  three 
cases  is  C-H  or  C,  although  in  three  others, 
it  is  H  or  H-C.  Thus,  the  frequency  of  the 
type  of  response  does  not  invariably  depend 
on  the  length  of  the  reaction  to  separate 
stimuli.  Indeed,  as  results  show,  the  entire 
character  of  the  disturbance  may  be  greater 
for  hot  in  double  stimuli,  in  spite  of  a  slower 
cold  reaction.  The  opposite,  however,  does 
not  occur. 

Another  point  of  interest  is  the  effect  of 
double  stimulation  upon  the  length  of  reac- 
tion-time.    If  the  gains  in  the  medians  for 


the  double  stimulus  over  the  single,  for  each 
region,  are  added  algebraically,  for  each  sub- 
ject, we  get  a  rough  measure  of  the  effect  of 
the  double  stimulus.  This  is  shown  in  Table 
12.  The  same  sort  of  measure  for  normals 
can  be  easily  computed  from  Table  12  of  the 
former  article.  It  will  show  that  while  the  re- 
action to  cold  remained  practically  the  same  in 
C-H  responses  as  in  single  stimuli  (sum  of  the 
gains,  total,  equals  — .1  second),  the  reaction 
to  H  in  H-C  responses  was  somewhat  length- 
ened (sum  of  gains,  +2.9  seconds). 

The  tendency  of  the  clinical  subjects  is  in 
general  to  increase  the  time  for  either  response 
in  double  stimuli.  The  increase  is  greater  for 
hot  than  for  cold  in  tsvelve  cases,  and  less  in 


370 


Temperature  Sensitivity 


five — the  remaining  five  patients  having  too 
few  H-C  responses  to  admit  of  comparison. 
The  five  cases  showing  less  increase  for  hot 
than  for  cold  are  not,  however,  of  those  who 
react  more  slowly  to  cold.  There  are  four 
cases  that  show  a  decrease  in  time  of  cold  in 
double  stimuli;  in  only  one,  however,  is  the 
difference  very  considerable.  There  is  but  one 
case  showing  a  decrease  in  time  of  hot;  this 
is  the  subject  who  reacted  to  almost  all 
stimuli — single  and  double — by  H-C.  The 
tendency  is,  then — as  in  normals — for  double 
stimuli  to  increase  the  reaction-time  of  hot 
more  than  of  cold. 

This  leads  us  to  the  third  point  of  general 
interest:  that  the  C-H  type  of  response  in- 
dicates the  least  abnormality  of  response.  It 
was  noted  even  among  normals  that  H-C 
responses  were  more  irregular  when  they 
occurred  than  C-H,  but  it  was  assumed  that 
this  was  because  of  the  fewer  number  of  cases 
of  this  type.  Among  the  subjects  of  the 
present  inquiry  the  same  phenomenon  ap- 
pears. A  slighter  degree  of  disturbance  for 
C-H  than  for  H-C  responses  is  shown  by 
every  subject — whether  cold  or  hot  is  more 
disturbed — in  the  time  of  either  first  or  second 
interval,  or  the  proportion  of  extreme  reac- 
tions, or  in  all  three  ways — except  in  the  case 
of  D.  L.,  in  whom  H-C  responses,  although 
less  frequent,  are  shorter  in  both  intervals 
and  less  apt  to  be  extreme.  Single  responses 
to  double  stimuli,  are  in  general,  longer  and 
more  apt  to  be  extreme  than  double  responses; 
that  is,  they  indicate  the  greatest  divergence 
from  the  normal,  except  in  multiple  sclerosis, 
where  the  only  significant  divergence  is  the 
lengthening  of  the  second  interval. 

Here  it  may  be  observed  that  this  seems  to 
imply  that  the  process  of  dissociation  in 
multiple  sclerosis  is  of  a  different  character 
from  that  in  syringomyelia  or  tabes  in  that, 
instead  of  retarding  the  initial  perception 
when  the  double  stimulus  is  given,  the  ten- 
dency is  to  lengthen,  if  not  to  inhibit,  the  per- 
ception of  the  second.  Whereas  in  tabes,  the 
prolongation  of  the  initial  perception  is 
quite  marked  (c/.  Table  12).  In  syringo- 
myelia, however,  the  reaction  is  slow  even  for 
separate  stimuli,  and  the  curious  result  is 
that   in   three  subjects,    C-H   responses   are 


quicker  than  responses  to  cold  separately — 
another  proof  of  the  slighter  disturbance 
indicated  by  the  C-H  type  of  response.  It 
may  be  that  this  retardation  of  the  perception 
of  the  second  stimulus  is  dependent  on  the 
degree  of  disturbance  rather  than  charac- 
teristic of  a  particular  syndrome:  H.  T.,  a 
neuritis  case  with  scarcely  any  disturbance, 
and  J.  CI.,  a  syringomyelia  case  in  whom  the 
disturbance  is  quite  limited,  show  the  same 
general  tendency.  Nevertheless,  since  other 
subjects  in  whom  the  disturbance  is  slight  do 
not  show  it,  and  since  all  the  cases  of  multiple 
sclerosis  tested — even  those  in  whom  the 
dorsal  nerve  roots  had  been  severed — do  show 
it,  it  seems  fair  to  regard  it  as  characteristic 
of  multiple  sclerosis. 

To  return  to  the  points  of  theoretical  inter- 
est. The  three  tendencies  mentioned — that, 
even  when  cold  is  separately  more  delayed, 
hot  is  less  apt  to  predominate  in  double  stim- 
uli; that  in  general,  the  perception  of  hot  in 
double  stimuli  is  more  increased  in  time  than 
cold,  and  that  the  exceptions  to  this  are  not 
the  cases  in  which  cold  is  separately  slower; 
that  C-H  responses  are  nearest  to  normal 
whichever  sensation  is  more  disturbed — sug- 
gest that  the  double  stimulation  acts  in  a 
way  which  is  not  merely  the  additive  effect 
of  the  two  stimuli,  but  which  indicates  some 
relation  between  the  two  tending  to  delay  the 
perception  of  hot. 

The  theory  that  best  explains  these  facts, 
is,  in  my  opinion,  that  which  regards  the  per- 
ception of  hot  as  a  fusion  of  impulses  from  cold 
and  warm  spots.  On  this  hypothesis,  the 
double  stimulation  requires  the  cold  spots  to 
do  double  duty,  so  to  speak,  and  naturally 
the  fulfillment  of  their  secondary  function  is 
delayed.  This  hypothesis  also  explains  most 
easily  the  cases  of  perversion — at  least  those 
which  do  not  occur  with  complete  consistency. 
If  cold  takes  part  in  the  perception  of  hot,  then 
it  is  not  difficult  to  imagine  the  fusion  dis- 
turbed and  cold  perceived  as  hot  or  vice  versa. 
The  tendencies  are,  however,  not  sufficiently 
unequivocal  to  make  this  interpretation  of 
more  than  doubtful  correctness — and  there 
are  two  cases  whose  reaction  is  difficult, 
though  not  impossible,  to  explain  on  this 
assumption.     These   are  J.    CI.   and   J.   T., 


37^ 


Temperature  Sensitivity 


who  show  a  normal  reaction  to  cold  and 
hot  separately,  somewhat  quicker,  how- 
ever, for  hot,  but  a  considerable  interference 
with  the  reaction  to  cold  in  double  stimuli. 
It  is  difficult  to  see  how  the  reaction  to  hot 
can  remain  intact,  on  our  hypothesis,  when 
cold  is  disturbed.  It  is  necessary  to  assume 
that  the  cold,  in  exercising  its  second  function, 
loses  its  identity  in  its  first  function  because 
the  second  reaction  comes  so  quickly.  The 
number  of  instances  for  which  both  of  these 
subjects  started  to  say  "cold"  but  said  "hot" 
instead,  makes  this  explanation  not  improb- 
able. 

CONCLUSIONS 

1.  Patients  sufTering  from  syringomyelia, 
tabes  dorsalis,  multiple  sclerosis,  and  the  t\'pe 
of  thalamic  lesion  presented  in  this  study, 
generally  show  some  disturbance  in  reactions 
to  double  thermal  stimuli,  whether  or  not 
evinced  by  ordinary  clinical  tests.  The  tem- 
perature test,  as  herein  presented,  is  not, 
however,  well  adapted  to  the  investigation  of 
peripheral  disturbances. 

2.  There  is  a  larger  proportion  than  normal 
of  single  responses  to  double  stimuli. 

3.  There  is  more  than  a  normal  tendency, 
in  many  cases,  to  call  temperatures  of  41°  to 
44°C.  or  higher,  warm  instead  of  the  usual  hot. 

4.  The  disturbance  is  generally  shown  by 
an  increased  reaction-time. 

5.  The  variability  in  time  is  greater  than 
normal:  the  range  of  medians  for  different 
regions  being  greater  and  the  consistency  of 
single  areas  less. 

6.  Reactions  to  double  stimuli  are  in  general 
more  disturbed  than  reactions  to  single;  and 
H-C  responses  more  than  C-H. 

7.  C-H  responses  indicate  the  nearest  ap- 
proach to  the  normal  reaction;  they  are  the 
most  frequent  type  in  the  least  disturbed  cases 
(with  one  exception) ;  and  they  are  nearest  to 
normal  in  time  for  each  individual. 

8.  The  type  of  response  to  double  stimuli, 
and  the  character  of  disturbance,  cannot  be 
predicted  from  the  response  to  single  stimuli. 

9.  The  differences  between  the  different 
syndromes  are  sufficiently  distinct  to  be  sug- 
gestive, although  there  is  some  overlapping. 
Multiple  sclerosis  has  a  particularly  clear-cut 
characteristic — a  dissociation  of  the  percep- 
tion of  doubkness. 


10.  The  double  stimulation  acts  in  such  a 
way  as  to  delay  the  perception  of  hot  more 
often  than  that  of  cold. 

EXPL.\N.\TION  OF  T.\BLES 

Tables  1-5  show  the  median  reaction-times 
of  each  patient  in  the  five  syndromes  studied, 
both  for  separate  and  double  stimuli,  and  for 
each  type  of  response;  the  P.  E.,  the  number 
of  extreme  reactions,  and  the  total  number  of 
responses  for  each  region. 

Tables  6  and  7  present  the  evidences  of 
gross  disturbance — the  percentages  of  stimuli 
that  gave  failures  and  perverted  responses. 

Table  8  gives  the  percentages  of  consistency 
in  type  of  response  and  in  time,  as  is  explained 
above.  A  glance  at  the  italicized  figures 
shows  that  the  inconsistency  was  considerable 
among  these  subjects. 

Table  9  shows  the  percentages  of  responses 
that  were  warm  and  cool,  instead  of  Iiot  and 
cold,  in  both  separate  and  double  stimuli. 
This  is  quite  striking  in  view  of  the  fact  that 
seven  per  cent,  of  the  total  was  the  highest 
percentage  reached  by  normals. 

Table  10  gives  the  number  of  cases  for  each 
region  of  each  subject  in  which  an  intensifica- 
tion of  the  sensation  might  be  assumed  by  the 
reflex  accompaniment.  This  is  of  interest  in 
comparing  the  different  subjects  and  syn- 
dromes, although  no  standard  can  be  offered 
for  reference. 

Table  1 1  presents  a  comparison  of  the  time 
of  cold  and  hot  responses  in  single  stimuli. 
It  gives  for  each  subject  the  number  of  regions 
on  which  cold  gave  a  longer  time  than  Jwt 
with  the  average  difference  in  time;  the 
number  of  regions  and  the  average  time  differ- 
ence where  hot  was  longer  than  cold;  and  the 
number  of  regions  on  which  the  time  for  cold 
and  hot  was  the  same. 

Table  12  is  a  comparison  of  reaction-times 
of  cold  in  single  and  double  stimuli  and 
similarly  of  hot. 

Figures  1-5  present  graphically  the  manner 
in  which  responses  to  double  stimuli  were  dis- 
tributed among  the  different  types  of  response. 

Figure  6.  Figure  6  is  a  graph  showing  the 
distribution  of  extreme  reactions  among  the 
different  tjpes  of  response  in  the  various 
syndromes. 


VITA 


The  author  was  born  in  New  York,  November  28,  1892. 
She  graduated  from  Girls'  High  School,  Brooklyn,  received 
the  A.B.  degree  from  Cornell  University  where  she  was 
elected  to  Phi  Beta  Kappa,  and  pursued  graduate  study 
leading  to  the  degree  of   Ph.D.  at  Columbia  University. 


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